| NPI | 1821561887 |
|---|---|
| Doing Business As | GRAND AVENUE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | RYAN J. ROSS Owner/President 406-245-4922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-01-08 |