NPI age
19 years
Enumerated 2006-08-03
Across 1099 active dentist providers in Idaho.
2 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807539000 | |
| 05 (ID) | 000755500 |
Multi-provider organization. 2 individual providers on file at this primary address.
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