| NPI | 1275619090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE BERNELL MURDOCK Owner/Partner 208-529-4484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D1719) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |