| NPI | 1376929083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDREA LYNN STEBBINS Owner 406-862-3503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2024-11-14 |