| NPI | 1578777686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM W. CALHOUN President 208-322-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D1846) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |