Healthcare Provider Details

I. General information

NPI: 1689025850
Provider Name (Legal Business Name): LAURA CAPRON D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S 1ST ST
HAMILTON MT
59840-2813
US

IV. Provider business mailing address

620 S 1ST ST
HAMILTON MT
59840-2813
US

V. Phone/Fax

Practice location:
  • Phone: 406-375-9218
  • Fax:
Mailing address:
  • Phone: 406-375-9218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN-DEN-LIC-11510
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN-DEN-LIC-11510
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: