Idaho Facial Imaging LLC
NPI #1437178399 in Boise, Idaho
Provider Information
- NPI Number
- 1437178399
- Entity Type
- Organization
- Organization Name
- Idaho Facial Imaging LLC
- Primary Specialty
- Clinic/Center - Radiology
- Enumeration Date
- Jul 19, 2006
- Last Updated
- Aug 22, 2020
Practice Location
Authorized Official
- Name
- DR. BRADEN M STAUTS, DDS
- Title
- OWNER/PARTNER
- Phone
- (208) 514-4740
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Radiology — Radiology |
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