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General NPI Number Information
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NPI Number | 1760648091
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Entity Type | Individual
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Provider Name | ANDREW TIMOTHY ORDELHEIDE DDS
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Gender | Male
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 200 W RAILROAD AVE
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City | PLAINS
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State | MT
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Zip | 59859
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Country | US
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Telephone | 406-215-4705
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Fax | 406-258-0612
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Provider Business Mailing Address
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Address Line | PO BOX 837
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City | PLAINS
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State | MT
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Zip | 59859-0837
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Country | US
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Telephone | 406-826-3611
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Fax | 406-826-3613
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2416
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 57234
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2461
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License Number State | MT
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