| NPI | 1841459351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD KENITH WALKER Dentist 208-853-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D3586) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |