| NPI | 1164504189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA STRAUSS Financial Coordinator 406-756-2415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |