Missoula Oral Surgery

Organization Oral and Maxillofacial Surgery Clinic/Center · NPI 1255620928

Missoula Oral Surgery is an Oral and Maxillofacial Surgery Clinic/Center in Missoula, Montana. Licensed in Montana. Registered with an NPI since 2011.

Licensed in: MT
In the registry since: 2011

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Practice location Address checks out

3020 S Reserve St Ste C
Missoula, MT 59801-7644
Phone: (406) 552-9970

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

Specialties & licences

Oral and Maxillofacial Surgery Clinic/Center (primary)	Taxonomy 261QS0112X · Licence 2433 (MT)

Record details

NPI number	1255620928
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Grant Wiswell — Owner/Surgeon · (406) 552-9970
NPI enumerated	April 4, 2011
Last updated in NPPES	April 4, 2011
Mailing address	3020 S Reserve St, Suite C, Missoula, MT 59801-7644