| NPI | 1770750887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN A. MORRIS Owner 208-344-4334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: ID D-1998-OR) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2008-05-08 |