Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dental |
261QD0000X |
| NPI # | 1285947721 |
| LBN Legal business name | CHIEF JOSEPH DENTAL CLINIC, LLC |
| Authorized official | STEVEN ZOLLMAN - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/26/2010 |
| Last updated | 07/26/2010 - About 16 years ago |
| Identifiers | n/a |
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