| NPI | 1326281163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A. GAGNON Dentist/Owner 208-233-8620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-3946) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2009-04-09 |