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NPI Code Detail

MEDICARE: MIA KLUESNER DR

MEDICARE: MIA KLUESNER DR
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
1122300000XDentistDEN-DEN-LIC-33335MT

General Provider Information

NPI Number : 1861326316
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA KLUESNER DR
Provider Business Mailing Address
First Line : PO BOX 541
Second Line :
City : LAKESIDE
State : MT
Zip : 59922-0541
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5 4TH AVE E
Second Line :
City : POLSON
State : MT
Zip : 59860-2117
Country : US
Telephone Number : 406-883-5541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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Directions to “ MIA KLUESNER DR” Practice Location

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