Healthcare Provider Details

I. General information

NPI: 1861401077
Provider Name (Legal Business Name): CHRISTOPHER B LOOMIS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 HELENA AVE
HELENA MT
59601-3425
US

IV. Provider business mailing address

1930 9TH AVE
HELENA MT
59601-4759
US

V. Phone/Fax

Practice location:
  • Phone: 406-422-4990
  • Fax: 406-442-4939
Mailing address:
  • Phone: 406-457-8928
  • Fax: 406-457-8981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number9705
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9705
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: