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Individual

DR. BERT WELCH WINTERHOLLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2675 CENTRAL AVE, STE L8, BLGS, MT 59102-6686
(406) 259-7438
(406) 259-9729
Mailing address
2675 CENTRAL AVE, STE L8, BLGS, MT 59102-6686
(406) 259-7438
(406) 259-9729

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1820
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11-5011
MT
01
112397100
TITLE XIX - GROUP
WY
01
112449800
TITLE XIX - INDIVIDUAL
WY
01
1757
DENTIST
ND
01
1820
DENTIST
MT
01
18204
BLUE CROSS BLUE SHIELD
MT
01
6128
PIN
01
6593
DENTIST
NE
01
757
WYOMING
WY
01
830BW02
WY CONTROLLED SUBSTANCE
WY
Enumeration date
12/29/2006
Last updated
03/07/2023
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