NPI age
19 years
Enumerated 2006-09-11
Across 64 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 805496900 | |
| 05 (ID) | 805511300 |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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