| NPI | 1124684584 |
|---|---|
| Doing Business As | VICTORY DENTAL |
| Entity Type | Organization |
| Authorized Contact | TREVOR TAFOYA President 208-447-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2019-05-11 |