Provider Demographics
NPI:1245485648
Name:FORAN, MARJORIE (RDH, COM)
Entity type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:
Last Name:FORAN
Suffix:
Gender:F
Credentials:RDH, COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 TOWER ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5658
Mailing Address - Country:US
Mailing Address - Phone:406-449-3441
Mailing Address - Fax:
Practice Address - Street 1:38 S LAST CHANCE GULCH STE 202
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4103
Practice Address - Country:US
Practice Address - Phone:406-431-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT402124Q00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No124Q00000XDental ProvidersDental Hygienist