| NPI | 1679812002 |
|---|---|
| Doing Business As | TOOTH TOWN |
| Entity Type | Organization |
| Authorized Contact | ROBERT D. MCWHORTER President 208-237-1567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D-3451-PD) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D-4186-PD) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2013-02-05 |