Organization
KALISPELL REGIONAL MEDICAL CENTER INC
Active
Other names
Glacier Oral and Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA S ROBERTSON (PRESIDENT/CHIEF EXECUTIVE OFFICER)
(406) 752-1724
Entity
Organization
Contact information
Practice address
711 E 13TH ST, SUITE 101, WHITEFISH, MT 59937-2964
(406) 862-5656
(406) 862-6155
Mailing address
711 E 13TH ST, SUITE 101, WHITEFISH, MT 59937-2964
(406) 862-5656
(406) 862-6155
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
11198
MT
Other
Enumeration date
08/16/2016
Last updated
10/04/2017
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