| NPI | 1366004509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL KENT NIELSEN President 406-459-3263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2024-08-28 |