| NPI | 1841634581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DABELL Oral Surgeon 208-884-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: ID D-4099-OS) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |