| NPI | 1588868442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY TED HOPKINS Owner 208-733-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: ID D3944-OS) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2014-07-25 |