| NPI | 1861260093 |
|---|---|
| Doing Business As | TOWNSQUARE DENTAL OF BLACKFOOT |
| Entity Type | Organization |
| Authorized Contact | BOONE ALLEN Owner 208-785-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2023-12-18 |