Provider Demographics
NPI:1861727646
Name:GRIFFETH, RODERICK MORRISON (DDS)
Entity type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:MORRISON
Last Name:GRIFFETH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 HENRY CHAPPLE ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106
Mailing Address - Country:US
Mailing Address - Phone:406-259-7438
Mailing Address - Fax:406-259-9729
Practice Address - Street 1:625 HENRY CHAPPLE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106
Practice Address - Country:US
Practice Address - Phone:406-259-7438
Practice Address - Fax:406-259-9729
Is Sole Proprietor?:No
Enumeration Date:2009-10-12
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6202-151223S0112X
MT23931223S0112X
MT2393DENTAL1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT23934Medicaid