Individual
ROBERT RANDALL BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1341 MT HIGHWAY 282, FORT HARRISON, MT 59636-0232
(406) 447-7362
Mailing address
1341 MT HIGHWAY 282, PO BOX 232, CLANCY, MT 59634-9716
(406) 495-8858
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
M930
SD
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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