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Individual

MR. KENNETH SCOTT MACPHERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LD LICENSED DENTURIS

Contact information

Practice address
715 KENSINGTON AVE, #25B, MISSOULA, MT 59801
(406) 542-0609
(406) 721-7617
Mailing address
715 KENSINGTON AVE, #25B, MISSOULA, MT 59801
(406) 542-0609
(406) 721-7617

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
MT18
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0150241
MT
Enumeration date
01/16/2007
Last updated
07/08/2007
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