Provider Demographics
NPI:1871617811
Name:HARBRECHT, JUDITH (RDH)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:HARBRECHT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 GOLDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6592
Mailing Address - Country:US
Mailing Address - Phone:406-655-0216
Mailing Address - Fax:
Practice Address - Street 1:1614 GOLDEN BLVD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6592
Practice Address - Country:US
Practice Address - Phone:406-655-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT175124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0115005Medicaid