| NPI | 1528355583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D. BRENNICK Dentist 406-494-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT 1475) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MT 2355) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-06-28 |