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 |