Organization
MONTANA CHILDRENS DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN DELISLE DDS (OWNER)
(702) 339-7274
Entity
Organization
Contact information
Practice address
116 GLACIER DR STE 107, LOLO, MT 59847-9343
(702) 339-7274
Mailing address
116 GLACIER DR STE 107, LOLO, MT 59847-9343
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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