| NPI | 1497974141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R GARRARD Partner 208-436-6406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID d3400) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID d3965) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2016-03-08 |