Individual
MISS SUMMOR KILGORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, OMT
Contact information
Practice address
1099 COWBOY WAY, COLUMBIA FALLS, MT 59912-9068
(406) 291-0634
Mailing address
1099 COWBOY WAY, COLUMBIA FALLS, MT 59912-9068
(406) 291-0634
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DEN-RDH-1207
MT
125J00000X
Dental Therapist
Primary
DEN-RDH-1207
MT
Other
Enumeration date
09/15/2019
Last updated
09/15/2019
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