NPI | 1780606616 |
---|---|
Entity Type | Organization |
Authorized Contact | LINDA GORDON Director Of Insurance Coordination 208-882-3214 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2006-07-23 |
Last Update Date | 2023-03-07 |