| NPI | 1275802068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL FEHLING Managing Dentist 208-664-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-4015) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |