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General NPI Number Information
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NPI Number | 1245185768
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Entity Type | Organization
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Legal Business Name | BIG SKY DENTURE GROUP
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 2439 S 9TH ST W
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City | MISSOULA
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State | MT
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Zip | 59801-3256
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Country | US
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Telephone | 406-396-1392
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Fax |
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Provider Business Mailing Address
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Address Line | 2439 S 9TH ST W
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City | MISSOULA
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State | MT
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Zip | 59801-3256
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Country | US
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Telephone | 406-396-1392
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISTEN TINERVIN
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Credential | DD
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Telephone | 406-829-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122400000X
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Taxonomy Name | Denturist
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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