| NPI | 1992976765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARON R. STEVENS Orthodontist 208-468-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ID D3738-OR) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |