Provider Demographics
NPI:1265589063
Name:KINNEY, TODD AARON (DDS)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:AARON
Last Name:KINNEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 LARAMIE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718
Mailing Address - Country:US
Mailing Address - Phone:406-582-8500
Mailing Address - Fax:406-586-4291
Practice Address - Street 1:3502 LARAMIE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718
Practice Address - Country:US
Practice Address - Phone:406-582-8500
Practice Address - Fax:406-586-4291
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT19351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice