Provider Demographics
NPI:1255784211
Name:CAPRON FAMILY DENTAL PC
Entity type:Organization
Organization Name:CAPRON FAMILY DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPRON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-360-8854
Mailing Address - Street 1:620 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2813
Mailing Address - Country:US
Mailing Address - Phone:406-375-9218
Mailing Address - Fax:406-375-9015
Practice Address - Street 1:620 S 1ST ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2813
Practice Address - Country:US
Practice Address - Phone:406-375-9218
Practice Address - Fax:406-375-9015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-DEN-LIC-115101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty