| NPI | 1578815130 |
|---|---|
| Doing Business As | KOOTENAI FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | ALEXIS LAROSE President/Dentist 208-664-8283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ID D4454) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |