Healthcare Provider Details

I. General information

NPI: 1366977720
Provider Name (Legal Business Name): ERIC NYGARD, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18737 SORREL SPRINGS LN
FRENCHTOWN MT
59834
US

IV. Provider business mailing address

18737 SORREL SPRINGS LN
FRENCHTOWN MT
59834-9502
US

V. Phone/Fax

Practice location:
  • Phone: 406-414-0444
  • Fax:
Mailing address:
  • Phone: 406-876-3922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number1134504566
License Number StateMT

VIII. Authorized Official

Name: DR. ERIC NYGARD
Title or Position: DENTIST ANESTHESIOLOGIST/OWNER
Credential: DDS
Phone: 406-876-3922