State of Montana

NPI #1366748147 in Helena, Montana

Provider Information

NPI Number
1366748147
Entity Type
Organization
Organization Name
State of Montana
Subpart
Yes (part of a larger organization)
Parent Organization
STATE OF MONTANA
Primary Specialty
Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date
Jan 27, 2011
Last Updated
Jan 27, 2011

Practice Location

Address
1400 BROADWAY RM A116
City
Helena
State
Montana
ZIP Code
59620
Phone
(406) 444-3529

Authorized Official

Name
MICHELE S O'DONNELL
Title
BILLING AGENT
Phone
(406) 444-3529

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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