NPI age
19 years
Enumerated 2006-11-17
Across 64 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 60806 | BLUE CROSS |
| 01 (ID) | 000010010306 | RAILROAD |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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