| NPI | 1508031071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERON J. EVANS President 208-238-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D-3891) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |