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General NPI Number Information
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NPI Number | 1417873373
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Entity Type | Organization
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Legal Business Name | YELLOWSTONE ORTHODONTICS
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 1150 S 29TH AVE
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City | BOZEMAN
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State | MT
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Zip | 59718-4220
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Country | US
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Telephone | 406-587-1811
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Fax | 406-585-0295
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Provider Business Mailing Address
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Address Line | 1150 S 29TH AVE
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City | BOZEMAN
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State | MT
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Zip | 59718-4220
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Country | US
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Telephone | 406-587-1811
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Fax | 406-585-0295
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | CHRISTOPHER CARLSON
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Credential | DMD, MS
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Telephone | 406-587-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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