| NPI | 1528431665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GRAHAM WELTON CEO 406-366-0661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D4715) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D4714) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2015-11-12 |