NPI | 1518126978 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM SHANE SCHOLES President 208-658-8990 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D3619) |
Enumeration Date | 2008-06-02 |
Last Update Date | 2008-06-02 |