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NPI Code Detail

MEDICARE: BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC

MEDICARE: BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
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
1261QD0000XDental Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
163392OTHERMTBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891886768
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Provider Business Mailing Address
First Line : 445 CENTENNIAL AVE
Second Line :
City : BUTTE
State : MT
Zip : 59701-2870
Country : US
Telephone Number : 406-496-6007
Fax Number :
Provider Business Practice Location Address
First Line : 445 CENTENNIAL AVE
Second Line :
City : BUTTE
State : MT
Zip : 59701-2870
Country : US
Telephone Number : 406-496-6007
Fax Number :
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : KAYLA M MEDINA
Credential :
Telephone Number : 406-496-6045
Provider Enumeration Date : 09/27/2006
Last Update Date : 02/12/2026

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Practice Location Address:
445 CENTENNIAL AVE
BUTTE, MT
59701-2870
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1669478772 — DR. MICHAEL WAYNE STUART DDS
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445 CENTENNIAL AVE
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1003804998 — MS. CATHERINE MARIE WHITE MD
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445 CENTENNIAL AVE
BUTTE, MT
59701-2870
Practice Phone: 509-434-0313
Practice Fax: 509-444-8206
1588655088 — JENNIFER MARIE MIRANDA PHARM D.
Practice Location Address:
445 CENTENNIAL AVE
BUTTE, MT
59701-2870
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1841259330 — DR. TAMMY A COX PHARMD
Practice Location Address:
445 CENTENNIAL AVE
BUTTE, MT
59701-2870
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1841215167 — DR. SCOTT CORDELL OLSEN D.D.S.
Practice Location Address:
445 CENTENNIAL AVE
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59701-2870
Practice Phone: 406-496-6007
Practice Fax: 406-496-6020

Directions to “BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC ” Practice Location

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