| NPI | 1891954343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALAN PRATT Dentist 208-466-2458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-3499) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-18 |