NPI age
18 years
Enumerated 2008-04-23
Across 114 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 805759500 | |
| 01 (ID) | 9200611 | IDAHO SMILES PROVIDER |
Single-site organization. Only one practice location on file.
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