| NPI | 1609113455 |
|---|---|
| Doing Business As | BLACKFOOT FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CURTIS CARPENTER President 208-357-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: ID D-4169) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |