Provider Demographics
NPI:1043233216
Name:KIRKLAND, KRIS ARNOLD (DDS)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:ARNOLD
Last Name:KIRKLAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 W KAGY BLVD
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6052
Mailing Address - Country:US
Mailing Address - Phone:406-586-5008
Mailing Address - Fax:406-587-6181
Practice Address - Street 1:45 W KAGY BLVD
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6052
Practice Address - Country:US
Practice Address - Phone:406-586-5008
Practice Address - Fax:406-587-6181
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT14201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice