Healthcare Provider Details

I. General information

NPI: 1669324448
Provider Name (Legal Business Name): LONE PEAK DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47520 GALLATIN RD STE 1B
GALLATIN GATEWAY MT
59730-8712
US

IV. Provider business mailing address

47520 GALLATIN RD STE 1B
GALLATIN GATEWAY MT
59730-8712
US

V. Phone/Fax

Practice location:
  • Phone: 406-995-2510
  • Fax:
Mailing address:
  • Phone: 406-995-2510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: RYAN BLAIR BOSWELL
Title or Position: DENTIST OWNER
Credential: DDS
Phone: 406-800-0406