Individual
CRYSTAL SPRING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
105 GREY WOLF TRL, BOZEMAN, MT 59718-7677
(406) 581-5293
(406) 763-4637
Mailing address
105 GREY WOLF TRL, BOZEMAN, MT 59718-7677
(406) 581-5293
(406) 763-4637
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1008
MT
Other
Enumeration date
04/28/2014
Last updated
04/28/2014
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