Healthcare Provider Details

I. General information

NPI: 1477806768
Provider Name (Legal Business Name): ANGELA P POND RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3318 3RD AVENUE NORTH, SUITE 100
BILLINGS MT
59101
US

IV. Provider business mailing address

3318 3RD AVENUE NORTH, SUITE 100
BILLINGS MT
59101
US

V. Phone/Fax

Practice location:
  • Phone: 406-248-3149
  • Fax: 406-245-6636
Mailing address:
  • Phone: 406-248-3149
  • Fax: 406-245-6636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1023
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: