Organization
PEDIATRIC DENTAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY CLARKE (DENTIST)
(406) 652-5550
Entity
Organization
Contact information
Practice address
2700 GRAND AVE, SUITE B, BILLINGS, MT 59102-2680
(406) 652-5550
Mailing address
2700 GRAND AVE, SUITE B, BILLINGS, MT 59102-2680
(406) 652-5550
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1797
MT
Other
Enumeration date
03/30/2007
Last updated
08/22/2020
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