| NPI | 1326668542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAIA JERDE Co Owner 406-728-0397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2024-02-21 |