| NPI | 1912114273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HORNE Director 208-522-0310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: ID D-3456) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-01-18 |