Provider Demographics
NPI:1518495845
Name:CORE DENTAL CARE
Entity Type:Organization
Organization Name:CORE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHALSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-652-9100
Mailing Address - Street 1:1724 LONE PINE DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-8973
Mailing Address - Country:US
Mailing Address - Phone:507-316-2340
Mailing Address - Fax:
Practice Address - Street 1:2700 GRAND AVE STE C
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2682
Practice Address - Country:US
Practice Address - Phone:406-652-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT127951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty