| NPI | 1194136150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL B. DAVIDSON Olwner 208-667-5447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID d1813) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |