| NPI | 1346518834 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ROBERT MARSHALL President 406-761-0314  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MT 2384)  | 
| Additional Taxonomies | 261Q00000X Clinic/Center | 
| Enumeration Date | 2011-12-12 | 
| Last Update Date | 2025-03-03 |