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NPI Code Detail

MEDICARE: DIGGS DENTAL CARE

MEDICARE: DIGGS DENTAL CARE
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1265050439
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIGGS DENTAL CARE
Provider Business Mailing Address
First Line : 1547 S HIGGINS AVE STE 103
Second Line :
City : MISSOULA
State : MT
Zip : 59801-4226
Country : US
Telephone Number : 406-543-8591
Fax Number :
Provider Business Practice Location Address
First Line : 1547 S HIGGINS AVE STE 103
Second Line :
City : MISSOULA
State : MT
Zip : 59801-4226
Country : US
Telephone Number : 406-543-8591
Fax Number :
Authorized Official
Title or Position : OWNER/DENTIST
Name : DR. TANNER DIGGS
Credential : DDS
Telephone Number : 406-543-8591
Provider Enumeration Date : 07/14/2020
Last Update Date : 09/23/2020

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Directions to “DIGGS DENTAL CARE ” Practice Location

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