Healthcare Provider Details

I. General information

NPI: 1780416735
Provider Name (Legal Business Name): GRANT LAMBRECHT DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16332 BECKWITH ST
FRENCHTOWN MT
59834-9812
US

IV. Provider business mailing address

16649 IRENE CT
HUSON MT
59846-8511
US

V. Phone/Fax

Practice location:
  • Phone: 406-626-4337
  • Fax:
Mailing address:
  • Phone: 406-438-5487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number28450
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: