| NPI | 1104099118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDE D CHRISTENSEN Dentist/Owner 208-455-1816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D3741) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |