| The Vine Kids Dental | |
|
120 N 7th Ave Bozeman MT 59715-3304 | |
| (406) 404-8463 | |
| Not Available |
| Full Name | The Vine Kids Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 120 N 7th Ave, Bozeman, Montana |
| Authorized Official Name and Position | Ji Min Yochim (PRESIDENT) |
| Authorized Official Contact | 4064048463 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Vine Kids Dental Po Box 4708 Bozeman MT 59772-4708 Ph: () - | The Vine Kids Dental 120 N 7th Ave Bozeman MT 59715-3304 Ph: (406) 404-8463 |
| NPI Number | 1073073268 |
|---|---|
| Provider Enumeration Date | 03/22/2019 |
| Last Update Date | 03/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073073268 | NPI | - | NPPES |
| 1578899886 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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