| NPI | 1467697177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER K LOVELAND Owner 208-461-5459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID d3936) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ID d3908) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |