| NPI | 1356497473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R NEIL President 406-761-0314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MT 1358) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |