OrganizationActive
Missoula Oral Surgery
NPI 1255620928 · Oral and Maxillofacial Surgery Clinic/Center · Missoula, MT
Provider details
- NPI number
- 1255620928
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Grant Wiswell, Owner/Surgeon(406) 552-9970
- License
- 2433 (MT)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
3020 S Reserve St
Suite C
Missoula, MT 59801-7644
Phone: (406) 552-9970
Approximate (ZIP-level) locationGet directions
Mailing address
3020 S Reserve St
Missoula, MT 59801-7644
Registry dates
- Enumerated
- 2011-04-04
- Last updated
- 2011-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.