| NPI | 1942463187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS W. CROFT Owner 208-922-4149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ID D-3282) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |