| NPI | 1811395882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES JERMAN President/Owner 406-752-4375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MT 2442) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2016-09-19 |