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

Missoula Peditric Dentistry, PC

Organization Pediatric Dentistry · NPI 1205183852

Missoula Peditric Dentistry, PC provides Pediatric Dentistry in Missoula, Montana. Licensed in Montana. Registered with an NPI since 2012.

Licensed in
MT
In the registry since
2012
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

3020 S Reserve St Ste D
Missoula, MT 59801-7652 Not confirmed with CMS for 14 years — call before visiting
Phone: (406) 541-7334
Fax: (406) 541-7338
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 4170 (MT)

Record details

NPI number1205183852
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Tiede — Business Manager · (406) 541-7334
NPI enumeratedAugust 13, 2012
Last updated in NPPESAugust 13, 2012
Mailing address3020 S Reserve St Ste D, Missoula, MT 59801-7652

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