| NPI | 1821150160 |
|---|---|
| Doing Business As | PEACH ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | KARL DOUGLAS PEACH Orthodontist President 208-777-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ID N05306) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00007291) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 37273) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |