| NPI | 1407236821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL P. ROMRIELL Owner 208-478-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0700X Dentist, Prosthodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |