Provider Demographics
NPI:1841698222
Name:ADVANCED DENTAL PROFESSIONALS PLLC
Entity type:Organization
Organization Name:ADVANCED DENTAL PROFESSIONALS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:406-245-5556
Mailing Address - Street 1:176 S 32ND ST W
Mailing Address - Street 2:SUITE #2
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6867
Mailing Address - Country:US
Mailing Address - Phone:406-245-5556
Mailing Address - Fax:406-652-0485
Practice Address - Street 1:176 S 32ND ST W
Practice Address - Street 2:SUITE #2
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6867
Practice Address - Country:US
Practice Address - Phone:406-245-5556
Practice Address - Fax:406-652-0485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT20621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty