Provider Demographics
NPI:1457156374
Name:SMILE MONTANA DENTAL GROUP PLLC
Entity type:Organization
Organization Name:SMILE MONTANA DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-892-2104
Mailing Address - Street 1:400 12TH AVE WEST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912
Mailing Address - Country:US
Mailing Address - Phone:406-892-2104
Mailing Address - Fax:406-892-1422
Practice Address - Street 1:400 12TH AVE WEST
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912
Practice Address - Country:US
Practice Address - Phone:406-892-2104
Practice Address - Fax:406-892-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty