| NPI | 1710364427 |
|---|---|
| Doing Business As | NORTH IDAHO DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN L GATES Dentist/Owner 208-691-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ID D3355) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2020-08-17 |