| NPI | 1700294568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LYNN WESTERBERG Owner 208-323-7790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 292200000X Dental Laboratory (Licence: ID LD-92) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |