Individual
ERICK VINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
1103 MISSOURI AVE, BUTTE, MT 59701-4752
(406) 782-2900
Mailing address
1103 MISSOURI AVE, BUTTE, MT 59701-4752
(406) 782-2900
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
27
MT
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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