Provider Demographics
NPI:1013453141
Name:STOKKE FAMILY DENTISTRY, PLLC
Entity Type:Organization
Organization Name:STOKKE FAMILY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-628-8211
Mailing Address - Street 1:112 1ST AVE S
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-3399
Mailing Address - Country:US
Mailing Address - Phone:406-628-8211
Mailing Address - Fax:406-628-4423
Practice Address - Street 1:112 S 1ST AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-3359
Practice Address - Country:US
Practice Address - Phone:406-628-8211
Practice Address - Fax:406-628-4423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT16581223G0001X
MT114701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty