Healthcare Provider Details

I. General information

NPI: 1760834956
Provider Name (Legal Business Name): BILLINGS ORTHODONTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 S 32ND ST W A
BILLINGS MT
59102-6875
US

IV. Provider business mailing address

152 S 32ND ST W A
BILLINGS MT
59102-6875
US

V. Phone/Fax

Practice location:
  • Phone: 406-245-4414
  • Fax: 406-294-4416
Mailing address:
  • Phone: 406-245-4414
  • Fax: 406-294-4416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number1635
License Number StateMT

VIII. Authorized Official

Name: KERRI STEFFES
Title or Position: OFFICE MANAGER
Credential:
Phone: 406-245-4414