Provider Demographics
NPI:1972024610
Name:PRYOR, ELIF (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIF
Middle Name:
Last Name:PRYOR
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 1:3020 S RESERVE ST STE D
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-7652
Mailing Address - Country:US
Mailing Address - Phone:406-541-7337
Mailing Address - Fax:
Practice Address - Street 1:3020 S RESERVE ST STE D
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7652
Practice Address - Country:US
Practice Address - Phone:406-541-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT155281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice