Healthcare Provider Details

I. General information

NPI: 1710803325
Provider Name (Legal Business Name): GREGG SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 GRANT RD
BILLINGS MT
59102-7442
US

IV. Provider business mailing address

3032 ROSEBUD DR
BILLINGS MT
59102-6140
US

V. Phone/Fax

Practice location:
  • Phone: 406-613-7073
  • Fax:
Mailing address:
  • Phone: 920-850-4135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: