| 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 |