Organization
THE BRACE PLACE PLLP
Active
Other names
The Brace Place
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES W MASON DDS (PARTNER)
(406) 752-8686
Entity
Organization
Contact information
Practice address
34 BRUYER WAY, KALISPELL, MT 59901-6305
(406) 752-8686
Mailing address
34 BRUYER WAY, KALISPELL, MT 59901-6305
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112866
—
MT
Enumeration date
10/29/2014
Last updated
10/29/2014
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