| NPI | 1912356841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH PATRICK SCHMIDT Dentist, President 208-305-1091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ID D-4737) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2016-06-10 |