| NPI | 1487238689 |
|---|---|
| Doing Business As | TABLE ROCK ORAL SURGERY AND DENTAL IMPLANTS |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY OBRIEN Owner 208-412-0637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2024-04-10 |