MEDICARE: DR. CHAD CATTRON D.D.S.

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	390200000X	Student in an Organized Health Care Education/Training Program	2015021100	MO
2	1223P0221X	Pediatric Dentistry	DEN-DEN-LIC-13340	MT

General Provider Information

NPI Number	:	1477911618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAD CATTRON D.D.S.

Provider Business Mailing Address
First Line	:	155 HUTTON RANCH RD # 102
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-2133
Country	:	US
Telephone Number	:	406-916-9576
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 HUTTON RANCH RD # 102
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-2133
Country	:	US
Telephone Number	:	406-916-9576
Fax Number	:

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

Provider Enumeration Date	:	02/02/2016
Last Update Date	:	07/21/2022

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