NPI age
19 years
Enumerated 2006-08-25
Across 64 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002067800 | |
| 05 (ID) | 805105200 |
Part of a multi-provider practice. 21 other active providers share this practice address in NPPES.
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