| NPI | 1699949750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN KEMPERS Owner 208-376-4550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ID D-3407) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |