| NPI | 1790899409 |
|---|---|
| Doing Business As | MIDDLE CREEK DENTAL |
| Entity Type | Organization |
| Authorized Contact | SHAUN CHRISTENSEN Owner / Dentist 208-466-7424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D3588) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2019-09-20 |