Provider Demographics
NPI:1356647028
Name:TRUJILLO, JOSEPH JEREMY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JEREMY
Last Name:TRUJILLO
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:PO BOX 439
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59834-0439
Mailing Address - Country:US
Mailing Address - Phone:406-626-5520
Mailing Address - Fax:406-626-5468
Practice Address - Street 1:15276 BELKER LANE
Practice Address - Street 2:
Practice Address - City:FRENCHTOWN
Practice Address - State:MT
Practice Address - Zip Code:59834
Practice Address - Country:US
Practice Address - Phone:406-626-5520
Practice Address - Fax:406-626-5468
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2424122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist