| NPI | 1568779403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN T GATTEN Owner 208-664-9129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-1636) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D-4087) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2010-09-13 |