| NPI | 1538563564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY HOWARD BAGNELL Owner/Dentist 406-626-5520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT 1951) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |