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General NPI Number Information
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NPI Number | 1225545270
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Entity Type | Organization
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Legal Business Name | SMILES ACROSS MONTANA
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Dates
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Enumeration Date | 12/29/2017
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 105 GREYWOLF TRIAL
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City | BOZEMAN
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State | MT
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Zip | 59718-7677
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Country | US
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Telephone | 406-581-5293
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Fax |
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Provider Business Mailing Address
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Address Line | 105 GREYWOLF TRIAL
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City | BOZEMAN
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State | MT
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Zip | 59718-7677
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Country | US
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Telephone | 406-581-5293
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CRYSTAL SPRING
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Credential |
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Telephone | 406-581-5293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 4172
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License Number State | MT
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