| NPI | 1811156722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY MERRIMAN Owner 208-288-2719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D-3592-PD) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |