| NPI | 1346259777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTE ROSCOE EPPICH Member Dentist Owner 208-253-6077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ID D3548) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |