DR. TERRY KLISE D.D.S. NPI 1912921594

NPI Information

NPI: 1912921594
Provider Name: DR. TERRY KLISE, D.D.S.
Classification: Dentist - 1223D0004X
Entity Type: Individual

Specialization: Dentist Anesthesiologist

Address:
2603 DEER CANYON CT
MISSOULA, MT
ZIP 59808
Phone: (406) 529-2612
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DR. Terry Klise, D.D.S. is a dentist anesthesiologist dentist in Missoula, MT. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. DR. Terry Klise, D.D.S. NPI is 1912921594. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2603 DEER CANYON CT
MISSOULA, MT
ZIP 59808-638
Phone: (406) 529-2612
Fax: (406) 721-1126

The enumeration date for this NPI number is 7/27/2006 and was last updated on 7/28/2016.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	2229	MONTANA	No
2	1223D0004X	Dentist	Dentist Anesthesiologist	2229	MONTANA	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200317590	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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