Provider Demographics
NPI:1760834956
Name:BILLINGS ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:BILLINGS ORTHODONTICS, PLLC
Other - Org Name:BENNIONLAMBOURNE ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFFES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-245-4414
Mailing Address - Street 1:152 S 32ND ST W
Mailing Address - Street 2:A
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6875
Mailing Address - Country:US
Mailing Address - Phone:406-245-4414
Mailing Address - Fax:406-294-4416
Practice Address - Street 1:152 S 32ND ST W
Practice Address - Street 2:A
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6875
Practice Address - Country:US
Practice Address - Phone:406-245-4414
Practice Address - Fax:406-294-4416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT16351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1366696809Medicaid
MT1740342682Medicaid