Individual
DR. ANDREW TIMOTHY ORDELHEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
200 W RAILROAD AVE, PLAINS, MT 59859
(406) 215-4705
(406) 258-0612
Mailing address
PO BOX 837, PLAINS, MT 59859-0837
(406) 826-3611
(406) 826-3613
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2416
HI
122300000X
Dentist
Primary
2461
MT
1223G0001X
General Practice Dentistry
57234
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2416
STATE DENTAL BOARD OF HAWAII
HI
01
—
2461
MONTANA STATE BOARD OF DENTISTRY
MT
01
—
57234
STATE LICENSE
CA
Enumeration date
08/06/2008
Last updated
04/22/2020
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