| NPI | 1770769325 |
|---|---|
| Doing Business As | PHEASANT COVE DENTAL |
| Entity Type | Organization |
| Authorized Contact | KENT J ALLEN Owner 208-423-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA D1767) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |