| NPI | 1407152721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CHAD WOLFF Practising Dentist 208-461-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D4256) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2011-02-03 |