NPI age
19 years
Enumerated 2006-09-24
Across 1099 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 6O886 | BLUE CROSS OF IDAHO |
| 05 (ID) | 804073000 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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