| NPI | 1316192370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE ADAMSON Office Manager 208-529-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D-4196-PD) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2014-05-14 |