MEDICARE: DR. DON ALT SPURGEON DDS

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	1314	MT

General Provider Information

NPI Number	:	1427272210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DON ALT SPURGEON DDS

Provider Business Mailing Address
First Line	:	2615 16TH AVENUE SOUTH
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405
Country	:	US
Telephone Number	:	406-727-5343
Fax Number	:	406-727-9608

Provider Business Practice Location Address
First Line	:	2615 16TH AVENUE SOUTH
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405
Country	:	US
Telephone Number	:	406-727-5343
Fax Number	:	406-727-9608

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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