| 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 |