NPI | 1588827125 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD E. FERGUSON Owner 208-344-0908 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: ID D-1669-PE) |
Enumeration Date | 2008-07-03 |
Last Update Date | 2008-07-03 |