Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2245 | MT |
N | 1223D0001X | Dental Public Health | 2245 | MT |
Y | 1223G0001X | General Practice | 2245 | MT |
Y | 213EG0000X | General Practice | 2245 | MT |
NPI | 1194923334 |
---|---|
Provider Name | Dr. Steven James Shimamoto |
First Address | Billings, MT 59102 |
Second Address | Billings, MT 59102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 10/06/2013 |