| NPI | 1518495845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHALSEY NELSEN Secretary 406-652-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT 12795) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2017-05-31 |