Organization
THE VINE KIDS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JI MIN YOCHIM DMD (PRESIDENT)
(406) 404-8463
Entity
Organization
Contact information
Practice address
120 N 7TH AVE, BOZEMAN, MT 59715-3304
(406) 404-8463
Mailing address
PO BOX 4708, BOZEMAN, MT 59772-4708
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578899886
—
MT
Enumeration date
03/22/2019
Last updated
03/22/2019
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