Montana Dental Group LLC

NPI #1144767203 in Polson, Montana

Provider Information

NPI Number: 1144767203
Entity Type: Organization
Organization Name: Montana Dental Group LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 27, 2017
Last Updated: Jan 27, 2017

Practice Location

Address: 203 MAIN ST
City: Polson
State: Montana
ZIP Code: 59860-2119
Phone: (406) 883-0325

Authorized Official

Name: BRADY SEFCIK
Title: OFFICIAL
Phone: (801) 400-4560

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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