Provider Demographics
NPI:1326424524
Name:ORDELHEIDE DENTAL INC
Entity Type:Organization
Organization Name:ORDELHEIDE DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ORDELHEIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-826-3611
Mailing Address - Street 1:200 E RAILROAD
Mailing Address - Street 2:BOX 837
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-0837
Mailing Address - Country:US
Mailing Address - Phone:406-826-3611
Mailing Address - Fax:406-826-3614
Practice Address - Street 1:200 E RAILROAD
Practice Address - Street 2:BOX 837
Practice Address - City:PLAINS
Practice Address - State:MT
Practice Address - Zip Code:59859-0837
Practice Address - Country:US
Practice Address - Phone:406-826-3611
Practice Address - Fax:406-826-3614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2461122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty