MEDICARE: DENNIS K SACRY 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

General Provider Information

NPI Number	:	1508938986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENNIS K SACRY DDS

Provider Business Mailing Address
First Line	:	PO BOX 549
Second Line	:
City	:	WHITEHALL
State	:	MT
Zip	:	59759
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 FIRST STREET WEST
Second Line	:
City	:	WHITEHALL
State	:	MT
Zip	:	59759
Country	:	US
Telephone Number	:	406-287-3026
Fax Number	:

Authorized Official
Title or Position	:	OWNER PRES
Name	:	DR. DENNIS KEITH SACRY
Credential	:	DDS
Telephone Number	:	406-287-3026

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/22/2020

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