| NPI | 1720214521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD SEEGMILLER Owner 208-888-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D1983) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2009-06-08 |