| NPI | 1558675298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY C DABELL Surgeon 208-232-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: ID D-4276-OS) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-11-30 |