| NPI | 1578722765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID M LEWIS Owner/Dentist 208-888-5470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D-3810) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-03 |