Northwest Denture Center

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

License

DTR MT 18 Issued in MT

Legal business name

NORTHWEST DENTURE CENTER

Practice address

2021 S Higgins Ave
Missoula, MT 59801-6762

Phone

(406) 542-0609

Fax

(406) 721-7617

NPI assigned

Jun 7, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kenneth Scott Macpherson, LICENSED DENTURIST

Title

Owner

Phone

(406) 542-0609

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1679911044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 S HIGGINS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016762",
            "telephone_number": "406-542-0609",
            "fax_number": "406-721-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 S HIGGINS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016762",
            "telephone_number": "406-542-0609",
            "fax_number": "406-721-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DENTURE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "MACPHERSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-542-0609",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICENSED DENTURIST"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "MT",
            "license": "DTR MT 18",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1215088166",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Laboratory in Missoula, MT
• Providers in Missoula, MT by specialty
• Dental Laboratory in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.