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General NPI Number Information
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NPI Number | 1891184156
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Entity Type | Individual
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Provider Name | ROBIN GATES
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Gender | Female
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Dates
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Enumeration Date | 01/09/2015
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Last Update Date | 01/09/2015
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Provider Practice Location Address
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Address Line | 2621 15TH AVE S
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City | GREAT FALLS
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State | MT
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Zip | 59405-5201
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Country | US
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Telephone | 406-455-5903
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Fax |
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Provider Business Mailing Address
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Address Line | 1412 4TH AVE N
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City | GREAT FALLS
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State | MT
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Zip | 59401-1418
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Country | US
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Telephone | 406-788-0705
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 1255
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License Number State | MT
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