Provider Demographics
NPI:1649322777
Name:BIG SKY ENDODONTICS
Entity type:Organization
Organization Name:BIG SKY ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HAMLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:406-582-1515
Mailing Address - Street 1:3997 VALLEY COMMONS DR STE B
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-5617
Mailing Address - Country:US
Mailing Address - Phone:406-582-1515
Mailing Address - Fax:406-582-1919
Practice Address - Street 1:3997 VALLEY COMMONS DR STE B
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-5617
Practice Address - Country:US
Practice Address - Phone:406-582-1515
Practice Address - Fax:406-582-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2014122300000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No122300000XDental ProvidersDentistGroup - Single Specialty