| NPI | 1386315570 |
|---|---|
| Doing Business As | PRAIRIE MOUNTAIN DENTISTRY |
| Doing Business As | PRAIRIE MOUNTAIN DENTAL |
| Entity Type | Organization |
| Authorized Contact | JUSTIN HICKS President 406-868-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-10-11 |