MEDICARE: MRS. MARI ROSE KIESLING D.M.D.

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	122300000X	Dentist	8331302-9922	UT
2	1223P0221X	Pediatric Dentistry	6086	MT

General Provider Information

NPI Number	:	1306194931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARI ROSE KIESLING D.M.D.

Provider Business Mailing Address
First Line	:	3228 COLONIAL DR
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59601-8638
Country	:	US
Telephone Number	:	406-417-3456
Fax Number	:	406-417-3455

Provider Business Practice Location Address
First Line	:	3228 COLONIAL DR
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59601-8638
Country	:	US
Telephone Number	:	406-417-3456
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2012
Last Update Date	:	02/16/2026

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