Provider Demographics
NPI:1104324060
Name:ANDY B KEHMEIER, DDS
Entity type:Organization
Organization Name:ANDY B KEHMEIER, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:B
Authorized Official - Last Name:KEHMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-363-5200
Mailing Address - Street 1:710 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-3014
Mailing Address - Country:US
Mailing Address - Phone:406-363-5200
Mailing Address - Fax:406-204-0222
Practice Address - Street 1:710 S 1ST ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-3014
Practice Address - Country:US
Practice Address - Phone:406-363-5200
Practice Address - Fax:406-204-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT1639332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies