Individual
CODY FORKAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2425 CORNELL AVE, BUTTE, MT 59701-3848
(406) 494-7919
Mailing address
44 ANAVISTA RD, ANACONDA, MT 59711-2056
(406) 560-6583
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25984
MT
1223G0001X
General Practice Dentistry
25984
MT
Other
Enumeration date
06/12/2023
Last updated
04/02/2024
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