NPI | 1235565003 |
---|---|
Doing Business As | MUDROW FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | KEVIN RICHARD MUDROW Owner/General Dentist 208-524-2036 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2013-09-24 |
Last Update Date | 2013-09-24 |