MISSOULA ORAL SURGERY
NPI 1255620928
Clinic/Center - Oral and Maxillofacial Surgery in Missoula, MT

Active since April 04, 2011
3020 S RESERVE ST, SUITE C, MISSOULA, MT 59801(406) 552-9970 Get Directions Write a Review

NPPES record last updated: April 4, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Missoula Oral Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISSOULA ORAL SURGERY (NPI 1255620928) is a healthcare organization registered as an oral and maxillofacial surgery in Missoula, Montana and active in the NPI registry since April 2011. The organization lists Grant Matthew Wiswell, Owner/surgeon, as its authorized official.

NPPES Registry Identity

NPI1255620928
Entity TypeOrganization
Primary Taxonomy261QS0112X
Legal Business NameMISSOULA ORAL SURGERY
Location Address3020 S RESERVE ST, SUITE CMissoula, MT 59801-7644
Mailing Address3020 S Reserve St, Suite CMissoula, MT 59801-7644 · (406) 552-9970
Organization SubpartNo
Authorized OfficialGrant Matthew WiswellOwner/surgeon · (406) 552-9970
Enumeration DateApril 4, 2011
NPI 1255620928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Oral and Maxillofacial SurgeryAmbulatory Health Care Facilities
Taxonomy Code261QS0112X
License Licensed in MT · 2433
Definition

An oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

3020 S RESERVE ST, Missoula, MT 59801

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Pediatric Dentistry)
3020 S RESERVE ST, SUITE D
MISSOULA, MT 59801
Dentist (General Practice)
3020 S RESERVE ST
MISSOULA, MT 59801

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Missoula Oral Surgery's NPI number?

The NPI number for Missoula Oral Surgery is 1255620928. It was assigned to this organization in the NPPES registry on April 4, 2011.

Where is Missoula Oral Surgery located?

Missoula Oral Surgery is located at 3020 S Reserve St Suite C, Missoula, MT 59801. The listed phone number is (406) 552-9970.

What is Missoula Oral Surgery's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Oral and Maxillofacial Surgery, with taxonomy code 261QS0112X.

When was this NPI record last updated?

The NPPES record for Missoula Oral Surgery was last updated on April 4, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.