| NPI | 1902170368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN VERNAL SUTTON President 208-897-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-3979) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2018-06-20 |