| NPI | 1679665822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL A HIGER Owner President 208-384-9872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: ID D3196PD) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |