| NPI | 1346510237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT GRAFF PRYOR Dentist 208-734-7415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID 1223P0221X) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2012-11-13 |