Basic Information
Provider Information
NPI: 1982683793
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWNING
FirstName: MICHAEL
MiddleName: H
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2454 TETON AVE
Address2:  
City: BILLINGS
State: MT
PostalCode: 591020567
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 123 S 27TH ST
Address2:  
City: BILLINGS
State: MT
PostalCode: 591014200
CountryCode: US
TelephoneNumber: 4062473350
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/10/2006
LastUpdateDate: 10/08/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001X1225MTN Dental ProvidersDentistGeneral Practice
1223D0001X1225MTY Dental ProvidersDentistDental Public Health

No ID Information.


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