| NPI | 1861898991 |
|---|---|
| Doing Business As | PUENTE A LA SALUD DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JASON BROWN Chief Executive Officer 208-899-9631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2023-10-23 |