| NPI | 1851312839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBBIE ROLAND HAMBLIN Manager 208-461-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID 3312) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |