=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134921091
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COLE FUNSETH DDS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2025
-----------------------------------------------------
Last Update Date | 10/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 114 13TH ST S
-----------------------------------------------------
City | GREAT FALLS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59401-3816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-231-0072
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 114 13TH ST S
-----------------------------------------------------
City | GREAT FALLS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59401-3816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-454-3711
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DENTIST
-----------------------------------------------------
Name | COLE FUNSETH
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 406-454-3711
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------