Provider Demographics
NPI:1104022607
Name:OSTBY, MARLENE AMY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:AMY
Last Name:OSTBY
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 AVENUE E STE A
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2943
Mailing Address - Country:US
Mailing Address - Phone:406-259-6774
Mailing Address - Fax:406-657-6576
Practice Address - Street 1:1701 AVENUE E STE A
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2943
Practice Address - Country:US
Practice Address - Phone:406-259-6774
Practice Address - Fax:406-657-6576
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212901223X0400X
MT23361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics