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Joanna Vaughey Wales

Dentist

Dental Providers

112 W Lewis St, Livingston, MT 59047-3011

PECOS Enrollment

This provider is enrolled in PECOS as JOANNA WALES.

Based on the most recent information from CMS, provider Joanna Vaughey Wales is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 23 days ago.

Profile Details

Provider ID
1194906735
Provider Type
Individual
Full Name
Wales, Joanna Vaughey
Title
Dr.
Credential
D.D.S.

Gender
Female
Sole Proprietor
No
Enumeration Date
11/26/2007
Last Updated
4/6/2011

Contact Information

Practice Location

112 W Lewis St, Livingston, MT 59047-3011

(406) 922-0881

Unlisted Fax

Mailing Location

112 W Lewis St, Livingston, MT 59047-3011

(406) 922-0881

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 2071 Montana

Joanna Vaughey Wales

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Venable, William J.

Shaneyfelt, Mark Edward

Scott, Kevin Graham

Jagodzinski, Gary A

Theodore K. Kulaga, D.D.S., P. C.

Frederickson, Wayne Anthony

Blavatsky, Elizabeth

Livingston Dental Care

Schoelch, Michael L