Provider Demographics
NPI:1841380961
Name:SCHULTZ, DENNY LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNY
Middle Name:LEE
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:DENNIS
Other - Middle Name:LEE
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:720 2ND STREET EAST
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-755-4766
Mailing Address - Fax:406-755-4774
Practice Address - Street 1:720 2ND STREET EAST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-755-4766
Practice Address - Fax:406-755-4774
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT1429122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT139711Medicaid
MT5511493OtherCHIP
706714OtherTRICARE UNITED CONCORDIA