Organization
GALLATIN VALLEY PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL SAYRE (CEO)
(406) 599-9086
Entity
Organization
Contact information
Practice address
115 W KAGY BLVD, SUITE C, BOZEMAN, MT 59715-6027
(406) 587-2327
(406) 587-3338
Mailing address
115 W KAGY BLVD, SUITE C, BOZEMAN, MT 59715-6027
(406) 587-2327
(406) 587-3338
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2212
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0033436
—
MT
Enumeration date
04/18/2007
Last updated
08/22/2020
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