| NPI | 1891918603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL T MCHUGH President 208-238-0125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D1755) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-09-07 |