| NPI | 1386020550 |
|---|---|
| Doing Business As | IMPLANTS NORTHWEST |
| Entity Type | Organization |
| Authorized Contact | DANIEL CULLUM President 208-667-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: ID D-3149-OS) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |