Individual
CHRISTIAN RANDALL KENWORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S, M.S.
Contact information
Practice address
690 SW HIGGINS AVE STE F, MISSOULA, MT 59803-1433
(406) 721-2796
Mailing address
690 SW HIGGINS AVE STE F, MISSOULA, MT 59803-1433
(406) 721-2796
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1976
MT
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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