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General NPI Number Information
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NPI Number | 1053955963
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Entity Type | Organization
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Legal Business Name | HELMS FAMILY DENTAL PRACTICE PC
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 1547 S HIGGINS AVE
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City | MISSOULA
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State | MT
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Zip | 59801-4226
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Country | US
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Telephone | 406-728-3848
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 RAFFERTY LN
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City | MISSOULA
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State | MT
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Zip | 59804-6104
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Country | US
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Telephone | 406-721-8250
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON HELMS
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Credential | DMD
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Telephone | 406-721-8250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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