Provider Demographics
NPI:1346256187
Name:KEHMEIER, ANDY BRYAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:ANDY
Middle Name:BRYAN
Last Name:KEHMEIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 SOUTH FIRST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840
Mailing Address - Country:US
Mailing Address - Phone:406-363-5200
Mailing Address - Fax:406-363-5200
Practice Address - Street 1:710 SOUTH FIRST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840
Practice Address - Country:US
Practice Address - Phone:406-363-5200
Practice Address - Fax:406-363-5200
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT11256Medicaid