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General NPI Number Information
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NPI Number | 1508657545
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Entity Type | Organization
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Legal Business Name | BIG HORN SURGERY CENTER LLC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 3415 AVENUE E
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City | BILLINGS
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State | MT
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Zip | 59102-6561
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Country | US
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Telephone | 406-248-3303
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 ZIMMERMAN TRL STE 1
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City | BILLINGS
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State | MT
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Zip | 59102-7654
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Country | US
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Telephone | 406-248-3303
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRADY KELLER
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Credential | DMD
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Telephone | 406-671-2483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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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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Taxonomy #9
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #10
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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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Taxonomy #11
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 1223X0008X
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Taxonomy Name | Oral and Maxillofacial Radiology Dentistry
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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