Provider Demographics
NPI:1760112932
Name:YOUNG, KRISTINA E (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:E
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8707 JACKRABBIT LN, STE. C
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714
Mailing Address - Country:US
Mailing Address - Phone:406-813-8551
Mailing Address - Fax:406-813-8519
Practice Address - Street 1:8707 JACKRABBIT LN, STE. C
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714
Practice Address - Country:US
Practice Address - Phone:406-813-8551
Practice Address - Fax:406-813-8519
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-12
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist