| NPI | 1043644388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYNE MCCORD Owner 208-529-8333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2013-08-22 |