| NPI | 1215465471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSH ROBERT WESTERBERG Owner/Denturist 208-454-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122400000X Denturist (Licence: ID LD-92) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-07-21 |