Tiede, Susan Bon

Tiede, Susan Bon is an individual health care provider with primary practice located at 3020 S Reserve St Ste D Suite B, Missoula MT 59801-7652. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Tiede, Susan Bon can be contacted via phone (406) 541-7334.

Contact Information

Primary practice address
3020 S Reserve St Ste D Suite B Missoula MT 59801-7652
Phone: (406) 541-7334
Fax: (406) 541-7338
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 5820 Nebraska
Dental Providers / Pediatric Dentistry 1223P0221X 2151 Montana

Profile Details

NPI number 1558308221
LBN Legal business name Tiede, Susan Bon
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated Oct 5th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558308221 NPPES
Montana MEDICAID 0113191
Montana Other 1942483524

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