Provider Demographics
NPI:1295226330
Name:DAVID D. SEMRAU, DDS, PC
Entity Type:Organization
Organization Name:DAVID D. SEMRAU, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BETTYE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:JEUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-752-2372
Mailing Address - Street 1:221 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3013
Mailing Address - Country:US
Mailing Address - Phone:406-752-2372
Mailing Address - Fax:
Practice Address - Street 1:221 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3013
Practice Address - Country:US
Practice Address - Phone:406-752-2372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental