Joel Edward Courtial, DDS Valid NPI

Individual provider · General Practice Dentistry · Eagle, ID

NPI

1124193123

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

D1743 (ID)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-11-22

Last updated

2007-07-08