Provider Demographics
NPI:1609079961
Name:FIEHRER, DANIEL RAYMOND (DDS PC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RAYMOND
Last Name:FIEHRER
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 N RODNEY ST
Mailing Address - Street 2:SUITE #5
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3514
Mailing Address - Country:US
Mailing Address - Phone:406-442-0288
Mailing Address - Fax:406-442-0344
Practice Address - Street 1:1111 N RODNEY ST
Practice Address - Street 2:SUITE #5
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3514
Practice Address - Country:US
Practice Address - Phone:406-442-0288
Practice Address - Fax:406-442-0344
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT120081Medicaid