FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY MONTANA PC NPI 1407116338

NPI Information

FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY MONTANA PC is an ambulatory surgical clinic center in Missoula, MT. FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY MONTANA PC NPI is 1407116338. The provider is registered as an organization entity type.
The provider Is Doing Business As Cosmetic Surgical Arts Center.

The provider's business location address is:

805 S RESERVE ST
MISSOULA, MT
ZIP 59801-104
Phone: (406) 549-6600
Fax: (406) 549-1511

The provider's authorized official is Clark O Taylor .
The authorized official title is Owner and has the following contact phone number (406) 549-6600.

The enumeration date for this NPI number is 5/25/2012 and was last updated on 1/23/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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