MEDICARE: AARON STENSVAD DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	D8114	OR
2	122300000X	Dentist	17294	MT

General Provider Information

NPI Number	:	1346235306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON STENSVAD DMD

Provider Business Mailing Address
First Line	:	PO BOX 5030
Second Line	:
City	:	FORSYTH
State	:	MT
Zip	:	59327-5030
Country	:	US
Telephone Number	:	406-346-2131
Fax Number	:

Provider Business Practice Location Address
First Line	:	1617 MAIN ST
Second Line	:
City	:	FORSYTH
State	:	MT
Zip	:	59327-5030
Country	:	US
Telephone Number	:	406-346-2131
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	05/06/2019

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