MEDICARE: TOM RICHARD LIDAHL D.M.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	1223G0001X	General Practice Dentistry	1327	MT
2	122300000X	Dentist	D10463	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13274	OTHER	MT	BCBS PROVIDER NUMBER
2	5510244	OTHER	MT	CHIP PROVIDER NUMBER
3	991068	OTHER	ND	BCBS PROVIDER NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720081201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOM RICHARD LIDAHL D.M.D.

Provider Business Mailing Address
First Line	:	223 N MAIN ST
Second Line	:
City	:	PLENTYWOOD
State	:	MT
Zip	:	59254-1843
Country	:	US
Telephone Number	:	406-765-2700
Fax Number	:	406-765-1514

Provider Business Practice Location Address
First Line	:	223 N MAIN ST
Second Line	:
City	:	PLENTYWOOD
State	:	MT
Zip	:	59254-1843
Country	:	US
Telephone Number	:	406-765-2700
Fax Number	:	406-765-1514

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	09/11/2025

Similar Medicare Providers

1235396383 — STEVENS DENTAL GROUP, PC
Practice Location Address:

223 N MAIN ST
PLENTYWOOD, MT
59254-1843

Practice Phone: 406-765-2700
Practice Fax:

1063235364 — MONTE C. STEVENS DDS PC
Practice Location Address:

223 N MAIN ST
PLENTYWOOD, MT
59254-1843

Practice Phone: 407-765-2700
Practice Fax:

1467452102 — SHERIDAN MEMORIAL HOSPITAL ASSOCIATION
Practice Location Address:

440 W LAUREL AVE
PLENTYWOOD, MT
59254-1526

Practice Phone: 406-765-3700
Practice Fax: 406-765-3800

1073514428 — PLENTYWOOD DRUG INC.
Practice Location Address:

119 N MAIN ST
PLENTYWOOD, MT
59254-1817

Practice Phone: 406-765-1810
Practice Fax:

1710939442 — SHERIDAN MEMORIAL HOSPITAL ASSOCIATION
Practice Location Address:

440 W LAUREL AVE
PLENTYWOOD, MT
59254-1526

Practice Phone: 406-765-3700
Practice Fax: 406-765-3800

1629020359 — SHERIDAN MEMORIAL HOSPITAL ASSOCIATION
Practice Location Address:

440 W LAUREL AVE
PLENTYWOOD, MT
59254-1526

Practice Phone: 406-765-3700
Practice Fax: 406-765-3800

Directions to “ TOM RICHARD LIDAHL D.M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.