NPI 1356917850

Elijah Jacob Grayson

Practitioner Dental Assistant Malmstrom Afb, MT

Practice location

Address: 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701
Phone: (406) 731-2511

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X

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Registry record

NPI: 1356917850
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Jun 2021
Record last updated: 3 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.