| NPI | 1972833846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED L SAYRE Owner 406-728-4032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MT 1308) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MT 2138) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2009-12-28 |