NPI | 1437728383 |
---|---|
Doing Business As | IDAHO PERIO. CENTER FOR DENTAL IMPLANTS AND LASER PERIODONTAL THERAPY |
Entity Type | Organization |
Authorized Contact | KIP KATSEANES Partner In Practice/Periodontist 843-530-4854 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics |
Enumeration Date | 2021-06-23 |
Last Update Date | 2021-06-23 |