Provider Demographics
NPI:1750659660
Name:DENNEHY, PADRAIG (DMD)
Entity Type:Individual
Prefix:DR
First Name:PADRAIG
Middle Name:
Last Name:DENNEHY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 SW HIGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1409
Mailing Address - Country:US
Mailing Address - Phone:406-728-0397
Mailing Address - Fax:
Practice Address - Street 1:521 SW HIGGINS AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1409
Practice Address - Country:US
Practice Address - Phone:406-728-0397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23721223X0400X
IDD-4327-OR1223X0400X
MND124801223X0400X
WI6456-151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics