| NPI | 1922188333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON R COOK Owner 208-377-8078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D1518) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2022-11-17 |