Provider Demographics
NPI:1376812982
Name:ASSOCIATED DENTAL CARE OF HELENA, PLLC
Entity Type:Organization
Organization Name:ASSOCIATED DENTAL CARE OF HELENA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCLELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-443-5526
Mailing Address - Street 1:121 N LAST CHANCE GULCH
Mailing Address - Street 2:SUITE E
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4159
Mailing Address - Country:US
Mailing Address - Phone:406-443-5526
Mailing Address - Fax:406-442-4034
Practice Address - Street 1:121 N LAST CHANCE GULCH
Practice Address - Street 2:SUITE E
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4159
Practice Address - Country:US
Practice Address - Phone:406-443-5526
Practice Address - Fax:406-442-4034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2317261QD0000X
MT1556261QD0000X
MT1557261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental