| NPI | 1013175595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN M SEPT Owner 208-882-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: ID D-4108-PD) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-05-30 |