| NPI | 1437573003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGHTON ROGER HOLLEY Manager 406-315-8004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT 6079) |
| Additional Taxonomies | 126800000X Dental Assistant |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-07-02 |