# GLACIER VALLEY ENDODONTICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750905063
- **Authorized official:** ERIN MOSELEY (PRESIDENT)
- **Authorized official phone:** (406) 250-9899

## Contact information

- **Practice address:** 80 FOUR MILE DR STE 15, KALISPELL, MT 59901-2665
- **Practice address phone:** (406) 257-3647
- **Mailing address:** 80 FOUR MILE DR STE 15, KALISPELL, MT 59901-2665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/02/2020
- **Last updated:** 06/02/2020