Individual
DR. CLAYTON ROLAND SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1315 US HIGHWAY 2 W, KALISPELL, MT 59901-3413
(406) 890-6364
Mailing address
1905 CHURCH DR, KALISPELL, MT 59901-7038
(406) 609-9996
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN-DEN-LIC-24480
MT
1223G0001X
General Practice Dentistry
10035MN
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10035MN
DENTAL LICENSE NUMBER
MN
01
—
DEN-DEN-LIC-24480
DENTAL LICENSE NUMBER
MT
Enumeration date
10/19/2005
Last updated
10/01/2025
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