MEDICARE: DAWN M. DALILI N.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	175F00000X	Naturopath	11-1247	AZ
2	175F00000X	Naturopath	AHC-NAT-LIC-1442	MT

General Provider Information

NPI Number	:	1427327741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN M. DALILI N.D.

Provider Business Mailing Address
First Line	:	2825 STOCKYARD RD STE A5
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-1542
Country	:	US
Telephone Number	:	405-540-4256
Fax Number	:	833-210-8436

Provider Business Practice Location Address
First Line	:	2825 STOCKYARD RD STE A5
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-1542
Country	:	US
Telephone Number	:	405-540-4256
Fax Number	:	833-210-8436

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

Provider Enumeration Date	:	12/15/2011
Last Update Date	:	08/26/2020

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