| NPI | 1265692321 |
|---|---|
| Doing Business As | PREVENTION DENTAL |
| Entity Type | Organization |
| Authorized Contact | GLEN K STEPHENSON President 208-375-4041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D3338) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2008-06-12 |