Individual
MR. CARL JUSTIN BRISENDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.D.
Contact information
Practice address
6 SUNSET PLZ, SUITE C, KALISPELL, MT 59901-3608
(406) 752-3733
(406) 752-3734
Mailing address
6 SUNSET PLZ, SUITE C, KALISPELL, MT 59901-3608
(406) 752-3733
(406) 752-3734
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
4206
MT
Other
Enumeration date
09/24/2012
Last updated
06/10/2013
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