| NPI | 1487789681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEAL P. WEBSTER Owner 208-459-3666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ID D-3560) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |