| NPI | 1942936406 |
|---|---|
| Doing Business As | BURLEY FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | TAYNE PETERSON Sole Mbr 208-670-4428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-09-07 |