| NPI | 1023181260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANETTE B.I. AULT Periodontist 406-549-4867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MT 2089) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |