| NPI | 1740924695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY HOFFMAN Owner 208-331-5080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-26 |