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General NPI Number Information
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NPI Number | 1730921289
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Entity Type | Organization
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Legal Business Name | BIG SKY PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 795 SUNSET BLVD, STE. C
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City | KALISPELL
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State | MT
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Zip | 59901
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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 | 795 SUNSET BLVD STE C
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City | KALISPELL
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State | MT
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Zip | 59901-3610
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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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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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