| NPI | 1205913209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R PAUL KELSON Dds Ms Pa 208-378-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ID D1561OR) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-07-09 |