Healthcare Provider Details

I. General information

NPI: 1164666889
Provider Name (Legal Business Name): JUSTIN HOWARD RHODES D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 E. HELENA ST
DILLON MT
59725
US

IV. Provider business mailing address

327 E. HELENA ST
DILLON MT
59725
US

V. Phone/Fax

Practice location:
  • Phone: 406-683-5121
  • Fax: 406-683-2856
Mailing address:
  • Phone: 406-683-5121
  • Fax: 406-683-2856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberMT2351
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: