| NPI | 1336036474 |
|---|---|
| Doing Business As | SNAKE RIVER SURGICAL |
| Entity Type | Organization |
| Authorized Contact | MAKELL CLAY Practice Manager 208-932-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-06-20 |
| Last Update Date | 2025-07-18 |