Missoula Pediatric Dentistry Pc is a Dental Clinic in Missoula, Montana. It is located at 1300 South Reserve St, Suite B, Missoula, MT and its contact number is 406-541-7334. The authorized person for Missoula Pediatric Dentistry Pc is Mr. Paul Leonard Tiede
who is Business Manager of the clinic and their contact number is 406-541-7334. The primary license number for Missoula Pediatric Dentistry Pc is MT2151 (Pediatric Dentistry) in Montana.
Missoula Pediatric Dentistry Pc Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Missoula Pediatric Dentistry Pc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Missoula Pediatric Dentistry Pc |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 1300 South Reserve St, Suite B, Missoula,
Montana, 59801 |
| Phone: | 406-541-7334 |
| Fax: | 406-541-7338 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Paul Leonard Tiede |
| Position: | Business Manager |
| Contact Number: | 406-541-7334 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Missoula Pediatric Dentistry Pc clinic are as mentioned below.
| NPI Number: | 1942483524 |
| NPI Enumeration Date: | 06 Dec, 2007 |
| NPI Last Update On: | 31 Jan, 2014 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Missoula Pediatric Dentistry Pc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | MT2151 | Montana | Primary | |
| General Practice | MT2229 | Montana | Secondary | |
| General Practice | MT2212 | Montana | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1558308221 | Medicaid | Montana | |
| 5512641 | Other | Montana | Chips |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Missoula Pediatric Dentistry Pc
1300 South Reserve St, Suite B
Missoula, Montana |
| Zip: | 59801 |
| Phone Number: | 406-541-7334 |
| Fax Number: | 406-541-7338 |
Patients can reach Missoula Pediatric Dentistry Pc at
1300 South Reserve St, Suite B, Missoula, Montana or can
call to book an appointment on 406-541-7334.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.