MEDICARE: ROBERT ALLAN BRONECKI D.D.S.

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	1898	MT

General Provider Information

NPI Number	:	1356592349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ALLAN BRONECKI D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 20161
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59104-0161
Country	:	US
Telephone Number	:	406-699-1992
Fax Number	:	406-259-2082

Provider Business Practice Location Address
First Line	:	926 MAIN ST STE 23
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-3359
Country	:	US
Telephone Number	:	406-252-1852
Fax Number	:	406-259-2082

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

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	12/06/2021

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