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General NPI Number Information
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NPI Number | 1407698962
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Entity Type | Organization
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Legal Business Name | BIG SKY PEDIATRIC POLSON PLLC
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 51045 US 93
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City | POLSON
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State | MT
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Zip | 59860
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Country | US
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Telephone | 406-752-8302
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Fax | 406-756-1953
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Provider Business Mailing Address
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Address Line | 51045 US HIGHWAY 93
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City | POLSON
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State | MT
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Zip | 59860-7194
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Country | US
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Telephone | 406-872-2111
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Fax | 406-872-2110
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Authorized Official
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Title or Position | MANAGER
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Name | DR. GABRIEL M DAWSON
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Credential | DDS, MS
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Telephone | 425-420-5943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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