| NPI | 1861818668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN RENCHER Dentist 406-449-0189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MT 2145) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2014-03-17 |