NPI | 1568621886 |
---|---|
Entity Type | Organization |
Authorized Contact | CASEY SCOTT BUTTERFIELD Owner 208-888-0625 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D3806) |
Enumeration Date | 2008-06-02 |
Last Update Date | 2008-06-02 |