| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 107 H Street E, Poplar, Montana |
| Authorized Official Name and Position | Julie Bemer (SERVICE UNIT DIRECTOR/CEO) |
| Authorized Official Contact | 4067682101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 67 Poplar MT 59255-0067 Ph: (406) 768-2101 | 107 H Street E Poplar MT 59255 Ph: (406) 768-2101 |
| NPI Number | 1457716227 |
|---|---|
| Provider Enumeration Date | 12/22/2015 |
| Last Update Date | 12/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457716227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DH00006133 (Washington) | Primary |