Provider Demographics
NPI:1942516349
Name:RATH, REBECCA A (DMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:RATH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 GRAND AVE STE E
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2682
Mailing Address - Country:US
Mailing Address - Phone:406-652-9204
Mailing Address - Fax:
Practice Address - Street 1:2700 GRAND AVE STE E
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2682
Practice Address - Country:US
Practice Address - Phone:406-652-9204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT79231223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT7923OtherDENTAL LICENSE
IDD4323OtherDENTAL LICENSE