| NPI | 1164684312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE AUSTEN PILLING Dentist 208-888-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D3877) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2017-05-01 |