NPI | 1154562783 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURA LINEBERRY Orthodontist 208-658-9470 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID d3184or) |
Enumeration Date | 2009-03-11 |
Last Update Date | 2009-03-11 |