| Elkhorn Family Dental, Llc | |
|
211 North Main Street Boulder MT 59632-0512 | |
| (406) 225-4222 | |
| (406) 225-4222 |
| Full Name | Elkhorn Family Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 211 North Main Street, Boulder, Montana |
| Authorized Official Name and Position | Charissa Foster Martin (OWNER) |
| Authorized Official Contact | 4062254222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elkhorn Family Dental, Llc Po Box 512 211 North Main Street Boulder MT 59632-0512 Ph: (406) 225-4222 | Elkhorn Family Dental, Llc 211 North Main Street Boulder MT 59632-0512 Ph: (406) 225-4222 |
| NPI Number | 1740546100 |
|---|---|
| Provider Enumeration Date | 04/10/2012 |
| Last Update Date | 04/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740546100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2386 (Montana) | Primary |
Boulder Valley Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 N Main St, Boulder, MT 59632 Phone: 406-225-4222 |