| NPI | 1730348236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY W JARDINE Owner Dentist 208-888-3540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D3807) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |