Healthcare Provider Details

I. General information

NPI: 1568041259
Provider Name (Legal Business Name): CHELSIE MORASKO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2527 6TH AVE S
GREAT FALLS MT
59405-3013
US

IV. Provider business mailing address

2527 6TH AVE S
GREAT FALLS MT
59405-3013
US

V. Phone/Fax

Practice location:
  • Phone: 406-952-1131
  • Fax:
Mailing address:
  • Phone: 406-698-3537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN-DEN-LIC-21477
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: