| NPI | 1538699707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN TA SEHEULT Dentist 406-892-4348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MT 13301) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |