| NPI | 1922479047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN L RENCHER Dentist 406-449-0189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MT 2145) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |