| NPI | 1518139039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JED KARL ZIRKER President 208-528-7665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D-3708) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |