Organization
MONTANA DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY SEFCIK (OFFICIAL)
(801) 400-4560
Entity
Organization
Contact information
Practice address
203 MAIN ST, POLSON, MT 59860-2119
(406) 883-0325
Mailing address
203 MAIN STREET, POLSON, MT 59860
(406) 883-0325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00202298
CO
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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