MEDICARE: CAST & CROWN DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1023946472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAST & CROWN DENTAL PLLC

Provider Business Mailing Address
First Line	:	2473 N BUNCHGRASS DR
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-7025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	424 3RD ST
Second Line	:
City	:	HAVRE
State	:	MT
Zip	:	59501-3644
Country	:	US
Telephone Number	:	406-265-7886
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	TYLER KURLE
Credential	:	DDS
Telephone Number	:	253-203-8775

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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Directions to “CAST & CROWN DENTAL PLLC ” Practice Location

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