| NPI | 1801098744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD H. GEORGE Owner 208-745-8704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D1828) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D3820) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |