| NPI | 1932119161 |
|---|---|
| Doing Business As | FAMILY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | RANDY LEE SORENSEN President 208-746-2668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ID D3092) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |