Provider Demographics
NPI:1730344953
Name:NAKI, TROY ON (DMD)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:ON
Last Name:NAKI
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 1:1700 WEST KOCH
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715
Mailing Address - Country:US
Mailing Address - Phone:406-586-4559
Mailing Address - Fax:406-586-0397
Practice Address - Street 1:1700 W KOCH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4148
Practice Address - Country:US
Practice Address - Phone:406-586-4559
Practice Address - Fax:406-586-0397
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice