Provider Demographics
NPI:1316294465
Name:SPIERLING, RALPH JOHN (DMD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:JOHN
Last Name:SPIERLING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 SW HIGGINS AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1460
Mailing Address - Country:US
Mailing Address - Phone:406-728-5100
Mailing Address - Fax:406-728-3342
Practice Address - Street 1:935 SW HIGGINS AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1460
Practice Address - Country:US
Practice Address - Phone:406-728-5100
Practice Address - Fax:406-728-3342
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT15851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0114218Medicaid