| NPI | 1003060591 |
|---|---|
| Doing Business As | ORAL AND FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | STEPHEN WILFORD HOLM Owner 208-743-1640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ID D-4057) |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2011-04-14 |