| NPI | 1922489673 |
|---|---|
| Doing Business As | PARKWAY DENTAL |
| Entity Type | Organization |
| Authorized Contact | TYSON GRAY Owner 208-342-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-30 |