NPI age
8 years
Enumerated 2017-07-03
Across 1099 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | D-4836 | IDAHO STATE BOARD OF DENTISTRY (DENTAL LICENSE) |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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