Provider Demographics
NPI:1457632671
Name:MORRISON FAMILY DENTISTRY PC
Entity Type:Organization
Organization Name:MORRISON FAMILY DENTISTRY PC
Other - Org Name:WINTERHOLLER DENTISTRY PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:WINTERHOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-652-0505
Mailing Address - Street 1:212 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-3014
Mailing Address - Country:US
Mailing Address - Phone:406-628-4418
Mailing Address - Fax:406-628-4000
Practice Address - Street 1:212 1ST AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-3014
Practice Address - Country:US
Practice Address - Phone:406-628-4418
Practice Address - Fax:406-628-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22011223G0001X
MT24581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty