Provider Demographics
NPI:1487681698
Name:CENTER, DEAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:M
Last Name:CENTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N 19TH
Mailing Address - Street 2:STE A
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718
Mailing Address - Country:US
Mailing Address - Phone:406-556-9740
Mailing Address - Fax:406-556-9741
Practice Address - Street 1:120 N 19TH STE A
Practice Address - Street 2:FAMILY DOCTORS URGENT CARE
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718
Practice Address - Country:US
Practice Address - Phone:406-556-9740
Practice Address - Fax:406-556-9741
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT96071OtherBCBS
MT0037453Medicaid
MT0037453Medicaid