| NPI | 1881140010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON SCOTT ASTIN Dentist 208-640-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 110831) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |