| NPI | 1801310008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW GREGORY PETERSON Periodontist, Member Of LLC 406-861-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: OR D9905) |
| Enumeration Date | 2017-07-29 |
| Last Update Date | 2017-07-29 |