Organization
KOOTENAI FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD E. MENDENHALL DDS (OWNER)
(406) 293-4116
Entity
Organization
Contact information
Practice address
204 E 6TH ST, LIBBY, MT 59923-2052
(406) 293-4116
(406) 293-6645
Mailing address
PO BOX 1379, LIBBY, MT 59923-1379
(406) 293-4116
(406) 293-6645
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1984
MT
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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