Provider Demographics
NPI:1538397054
Name:SCHWIETERMAN, DANIELLE CLAIRE (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:CLAIRE
Last Name:SCHWIETERMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3239
Mailing Address - Country:US
Mailing Address - Phone:406-586-2117
Mailing Address - Fax:
Practice Address - Street 1:301 N 15TH AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3239
Practice Address - Country:US
Practice Address - Phone:406-586-2117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice