Provider Demographics
NPI:1528400900
Name:EXPEDITON DENTISTRY
Entity Type:Organization
Organization Name:EXPEDITON DENTISTRY
Other - Org Name:SCOTT FREEMAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:406-652-7000
Mailing Address - Street 1:993 S 24TH ST W STE A
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7433
Mailing Address - Country:US
Mailing Address - Phone:406-652-7000
Mailing Address - Fax:406-652-7002
Practice Address - Street 1:993 S 24TH ST W STE A
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7433
Practice Address - Country:US
Practice Address - Phone:406-652-7000
Practice Address - Fax:406-652-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT42451223G0001X, 1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1164454138Medicaid