| NPI | 1619970076 |
|---|---|
| Doing Business As | FAMILY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | SHAWN D. MODULA General Manager 406-541-2889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT 2016) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-08-22 |