NPI | 1316320856 |
---|---|
Entity Type | Organization |
Authorized Contact | ELI K JOHNSON President 406-363-2421 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MT Den-den-lic-9616) |
Enumeration Date | 2015-07-01 |
Last Update Date | 2017-01-03 |