| NPI | 1982865390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT H. KIDO Owner 208-467-7401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D1804 and D1941) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |