Individual
JACOB MICHAEL CONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10 AVANTA WAY, BILLINGS, MT 59102-6873
(406) 655-4210
Mailing address
10 AVANTA WAY, BILLINGS, MT 59102-6873
(406) 655-4210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1294
AK
122300000X
Dentist
DEN-DEN-LIC-5935
MT
1223G0001X
General Practice Dentistry
Primary
5935
MT
Other
Enumeration date
06/17/2009
Last updated
10/29/2017
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