GLACIER ORAL AND MAXILLOFACIAL SURGERY PC – NPI #1043373012
Clinic/Center

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

GLACIER ORAL AND MAXILLOFACIAL SURGERY PC is an AHC clinic located in WHITEFISH, MT. NPPES has assigned the NPI number 1043373012 to GLACIER ORAL AND MAXILLOFACIAL SURGERY PC on December 19, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QS0112X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Oral and Maxillofacial Surgery

The NPI profile was previously updated about 3 years ago on Mar 07, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GLACIER ORAL AND MAXILLOFACIAL SURGERY PC below.

NPI Profile for
GLACIER ORAL AND MAXILLOFACIAL SURGERY PC

NPI Number
1043373012
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GLACIER ORAL AND MAXILLOFACIAL SURGERY PC
Primary location
711 13TH STR E
STE 101
WHITEFISH, MT 59937
Phone: (406) 862-5656 Fax: (406) 862-6155
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BERNADETTE WILSON
PRESIDENT
Phone: (406) 862-5656
Updated
Identifiers

Identifiers for GLACIER ORAL AND MAXILLOFACIAL SURGERY PC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherBLUE CROSS BLUE SHIELD IDMT95296
otherMONTANA DENTAL LICENSE #MT2235
otherMONTANA MEDICAL LICENSE #MT11198
medicaidMT0130186
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QS0112X
- Clinic/Center / Oral and Maxillofacial Surgery (Primary)
MT 11198

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.