| NPI | 1841573243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN SEALEY Vice President 406-443-2780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MT 1545MT) |
| Additional Taxonomies | 122300000X Dentist (Licence: MT 2207MT) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |