| NPI | 1790036705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN K. HINTZ President 208-762-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ID D3370) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |