| NPI | 1124186358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE R. CARSON Owner 406-377-8265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MT 1321) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2008-05-23 |