| NPI | 1659029353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI THOMPSON Owner Dentist 208-957-6301 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2022-03-13 |
| Last Update Date | 2022-03-13 |