| NPI | 1760682710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M ROSLING Office Manager 406-728-6840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MT 621111) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |