| NPI | 1366619694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W JASON CARTER Owner/Dentist 208-376-6346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D3384) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: ID D1401) |
| 1223G0001X Dentist General Practice (Licence: ID D3693) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |