| NPI | 1508433160 |
|---|---|
| Doing Business As | INTEGRATED DENTAL ARTS |
| Entity Type | Organization |
| Authorized Contact | TODD MATHESON Owner 208-351-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2021-06-10 |