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NPI Profile for Dr TERRY KLISE in MISSOULA, MT.
A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation’s Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dentist Anesthesiologist |
1223D0004X | |||
General Practice |
1223G0001X |
| NPI # | 1912921594 |
|
| Status | Active | |
| Credentials | DDS (Doctor of Dental Surgery) | |
| Entity | Individual | |
| Enumeration date | 07/27/2006 | |
| Last updated | 07/28/2016 - About 10 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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TERRY KLISE
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TERRY KLISE, DDS