| NPI | 1811417942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN CHAD LAMBOURNE Owner/Partner 406-245-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 1459) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 1399) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WY 1395) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-07-21 |