| NPI | 1275646259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD J WILLIAMS Partner 208-888-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D3220) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2016-05-12 |