Healthcare Provider Details

I. General information

NPI: 1841684990
Provider Name (Legal Business Name): AFFORDABLE DENTAL CARE PPLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 W. BROADWAY ST
PHILIPSBURG MT
59858
US

IV. Provider business mailing address

2823 LEXINGTON AVE
BUTTE MT
59701-3286
US

V. Phone/Fax

Practice location:
  • Phone: 406-859-4046
  • Fax: 406-494-7772
Mailing address:
  • Phone: 406-494-9300
  • Fax: 406-494-7772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2416
License Number StateMT

VIII. Authorized Official

Name: DR. ERIK HARRIS JOHNSON
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 406-494-9300