Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Missoula Pediatric Dentistry PC

Organization General Practice Dentistry · NPI 1942483524

Missoula Pediatric Dentistry PC provides General Practice Dentistry in Missoula, Montana. Licensed in Montana. Registered with an NPI since 2007.

Licensed in
MT
In the registry since
2007
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1300 S Reserve St Ste B
Missoula, MT 59801 Not confirmed with CMS for 12 years — call before visiting
Phone: (406) 541-7334
Fax: (406) 541-7338
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence MT2151 (MT)
General Practice Dentistry Taxonomy 1223G0001X · Licence MT2229 (MT)
General Practice Dentistry Taxonomy 1223G0001X · Licence MT2212 (MT)

Record details

NPI number1942483524
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Tiede — Business Manager · (406) 541-7334
NPI enumeratedDecember 6, 2007
Last updated in NPPESJanuary 31, 2014
Mailing address1300 South Reserve St, Suite B, Missoula, MT 59801

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