| NPI | 1093474660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL FRAZIER Owner 406-241-7653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2022-06-23 |