| NPI | 1982907242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE B. WASSMER Owner 406-652-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2024-09-04 |