NPI | 1174754964 |
---|---|
Entity Type | Organization |
Authorized Contact | JUSTIN LEE ROBISON President 208-841-8557 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE 60085472) |
Enumeration Date | 2009-07-28 |
Last Update Date | 2009-07-28 |