| NPI | 1972660769 |
|---|---|
| Former Legal Business Name | TIMOTHY W PENBERTHY DDS |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WALTHER PENBERTHY Owner 208-667-8622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: ID D1930EN) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2008-08-04 |