Provider Demographics
NPI:1346819372
Name:CONCHIERI, KEVIN R (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:R
Last Name:CONCHIERI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0519
Mailing Address - Country:US
Mailing Address - Phone:802-734-1088
Mailing Address - Fax:
Practice Address - Street 1:315 N 25TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1328
Practice Address - Country:US
Practice Address - Phone:406-248-6177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-DEN-LIC-214821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice