| NPI | 1174037113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE HILL Owner 208-521-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: ID DH-0982) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |