| NPI | 1326441411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT B. SIMMONS Dentist 208-746-3694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D3884) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |