| 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 |