Organization
HELENA DENTURE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS AARON HANSEMANN L.D. (OWNER)
(406) 442-4899
Entity
Organization
Contact information
Practice address
3404 COONEY DR, STE 106, HELENA, MT 59602-0215
(406) 442-4899
Mailing address
3404 COONEY DR, STE 106, HELENA, MT 59602-0215
(406) 442-4899
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
20
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150093
—
MT
Enumeration date
03/16/2010
Last updated
03/16/2010
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