Individual
EUGENE BOLLWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3224 10TH AVE S, GREAT FALLS, MT 59405-3449
(406) 727-1006
Mailing address
PO BOX 7050, GREAT FALLS, MT 59406-7050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1786
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112659
—
MT
01
—
1786
DELTA #
MT
01
—
17864
BCBS #
MT
01
—
5512284
CHIP #
MT
Enumeration date
05/02/2007
Last updated
07/08/2007
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