| NPI | 1992417117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN HILTON Managing Member 208-484-2376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-19 |