MEDICARE: PRICKLY PEAR PEDIATRIC DENTISTRY PC

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1487506366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRICKLY PEAR PEDIATRIC DENTISTRY PC

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	:

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	:	OWNER
Name	:	MRS. MARI ROSE KIESLING
Credential	:	DMD
Telephone Number	:	406-417-3456

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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