| NPI | 1093981011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WENDELL OWEN Dentist 208-523-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D3888) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-06-02 |