Jesse Lane Cole, DDS

Individual provider Active NPI General Practice Dentistry · Scobey, MT

NPI 1962672287 · NPPES record last updated Jan 20, 2015

Key facts

NPI
1962672287
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2425 (MT)
Practice address
504 Timmons St
Scobey, MT 59263-0250
Phone
(406) 487-2650
Fax
(406) 487-2620
NPI assigned
Mar 3, 2008
Sex
Male
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

State licenses

LicenseStateTypeSpecialty
D3990IDMDGeneral Practice Dentistry
2425MTMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D3990 ID
General Practice Dentistry 1223G0001X 2425 MT Yes

Addresses

Primary practice location

504 Timmons St
Scobey, MT 59263-0250

Mailing address

504 Timmons St
Scobey, MT 59263-0250
Phone (406) 487-2650

Other providers in Scobey, MT

All providers in Scobey, MT · General Practice Dentistry in Montana

Sources for this page

Verify at the official NPI Registry.