| NPI | 1134457153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R. HULL Dentist 208-852-0194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-1973) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |