| NPI | 1346824422 |
|---|---|
| Doing Business As | MAGIC VALLEY DENTAL ANESTHESIA PLLC |
| Entity Type | Organization |
| Authorized Contact | RYAN JUDD Owner 503-679-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2021-05-05 |