Individual
STEVEN ELIOT DELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
116 GLACIER DR STE 107, LOLO, MT 59847-9343
(406) 515-9655
Mailing address
116 GLACIER DR STE 107, LOLO, MT 59847-9343
(406) 515-9655
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11540
MT
122300000X
Dentist
5929
NV
122300000X
Dentist
7848
AZ
1223G0001X
General Practice Dentistry
56563
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11540
DENTAL LICENSE
MT
01
—
56563
STATE LICENSE
CA
01
—
5929
DENTAL LICENSE
NV
01
—
7848
STATE DENTAL LICENSE
AZ
Enumeration date
09/30/2008
Last updated
04/21/2026
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