| NPI | 1356643308 |
|---|---|
| Doing Business As | BLACKROCK DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOSHUA R. GIBBONS Owner 208-232-5294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ID D4330) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2019-11-27 |