Provider Demographics
NPI:1598051997
Name:MUIR, JOSHUA CLIFTON (DDS)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:CLIFTON
Last Name:MUIR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5470 ANNA MARIA DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-3705
Mailing Address - Country:US
Mailing Address - Phone:208-317-8400
Mailing Address - Fax:
Practice Address - Street 1:10 AVANTA WAY
Practice Address - Street 2:SUITE 3
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6873
Practice Address - Country:US
Practice Address - Phone:208-317-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4159122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist