Dorothy M Clark, RDH
Individual provider Active NPI Dental Hygienist · Libby, MT
NPI 1104490747 · NPPES record last updated May 18, 2021
Key facts
- NPI
- 1104490747
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- Practice address
- 320 E 2ND St
Libby, MT 59923-2010 - Phone
- (406) 283-6919
- NPI assigned
- May 18, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | Yes |
Addresses
Primary practice location
320 E 2ND St
Libby, MT 59923-2010
Mailing address
320 E 2ND St
Libby, MT 59923-2010
Phone (406) 283-6919
Other providers in Libby, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.