Provider Demographics
NPI:1053794131
Name:BIGHORN, DENNIS DEAN (LAC)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:DEAN
Last Name:BIGHORN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1530
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-1530
Mailing Address - Country:US
Mailing Address - Phone:406-234-0234
Mailing Address - Fax:406-234-0235
Practice Address - Street 1:124 CUSTER ST
Practice Address - Street 2:PUBLIC SERVICE BLDG.
Practice Address - City:WOLF POINT
Practice Address - State:MT
Practice Address - Zip Code:59201-1640
Practice Address - Country:US
Practice Address - Phone:406-653-1872
Practice Address - Fax:406-653-1775
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLAC 989101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)