| NPI | 1851753057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM OSTBY Owner 406-657-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MT 2392) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2018-03-17 |