Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 1575 | MT |
NPI | 1053487660 |
---|---|
Provider Name | Dr. D Briar Diggs |
First Address | Missoula, MT 59803 |
Second Address | Missoula, MT 59803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110789 | (05) | MT |