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General NPI Number Information
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NPI Number | 1669324448
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Entity Type | Organization
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Legal Business Name | LONE PEAK DENTAL PLLC
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 47520 GALLATIN RD STE 1B
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City | GALLATIN GATEWAY
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State | MT
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Zip | 59730-8712
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Country | US
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Telephone | 406-995-2510
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Fax |
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Provider Business Mailing Address
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Address Line | 47520 GALLATIN RD STE 1B
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City | GALLATIN GATEWAY
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State | MT
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Zip | 59730-8712
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Country | US
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Telephone | 406-995-2510
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | RYAN BLAIR BOSWELL
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Credential | DDS
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Telephone | 406-800-0406
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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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