Organization
ELKHORN FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARISSA FOSTER MARTIN DMD (OWNER)
(406) 225-4222
Entity
Organization
Contact information
Practice address
211 NORTH MAIN STREET, BOULDER, MT 59632-0512
(406) 225-4222
(406) 225-4222
Mailing address
PO BOX 512, 211 NORTH MAIN STREET, BOULDER, MT 59632-0512
(406) 225-4222
(406) 225-4222
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2386
MT
Other
Enumeration date
04/10/2012
Last updated
04/10/2012
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