| NPI | 1841450889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET D HEFNER Office Manager 208-343-4732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D3413) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2008-06-12 |