| NPI | 1528467925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR GRIFFITTS Oral And Maxillofacial Surgeon 208-667-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ID D4563-OS) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |