Healthcare Provider Details

I. General information

NPI: 1356397343
Provider Name (Legal Business Name): MONTANA INTERVENTIONAL AND DIAGNOSTIC RADIOLOGY SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MEDICAL PARK DR
HELENA MT
59601-4949
US

IV. Provider business mailing address

25 MEDICAL PARK DR
HELENA MT
59601-4949
US

V. Phone/Fax

Practice location:
  • Phone: 406-449-3211
  • Fax: 406-442-4863
Mailing address:
  • Phone: 406-449-3211
  • Fax: 406-442-4863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DENNIS PALMER
Title or Position: OWNER
Credential: MD
Phone: 406-449-3211