| NPI | 1821379009 |
|---|---|
| Former Legal Business Name | BAGNELL FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY HOWARD BAGNELL Owner/Dentist 406-676-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MT 1951) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2016-10-03 |