National Provider Identifier Database

STATE OF MONTANA
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

STATE OF MONTANA
1400 BROADWAY RM A116
HELENA, MT59620
Phone: 406-444-3529
Fax: 406-444-2750
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for STATE OF MONTANA

NPI Number 1639475411
Legal business name
LBN
STATE OF MONTANA
Authorized official MICHELE O'DONNELL - (BILLING AGENT)
Entity Organization
Organization subpart Yes
Enumeration date 01/27/2011
Last updated 01/27/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • MT Medicaid: 0260000
  • MT Other: 92046 BLUE CROSS BLUE SHELD OF MONTANA
  • MT Other: 92056 BLUE CROSS BLUE SHELD OF MONTANA
  • MT Other: 99248 BLUE CROSS BLUE SHELD OF MONTANA

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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