| NPI | 1972720936 |
|---|---|
| Doing Business As | ISU DENTAL HYGIENE CLINIC |
| Entity Type | Organization |
| Authorized Contact | BRIAN ROBERT CRAWFORD Program Director Dental Hygiene 208-282-5275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |