institution
Russell C. Pool, Dmd, Pa
Dental Clinic/Center in Nampa, Idaho
NPI 1093977647

Russell C. Pool, Dmd, Pa is a Dental Clinic/Center based in Nampa, ID and is specialized in Dental. Russell C. Pool, Dmd, Pa practices in Nampa, ID. The NPI Number for Russell C. Pool, Dmd, Pa is 1093977647 and holds a License No. D1687 (Idaho).

The current practice location address for Russell C. Pool, Dmd, Pa is 109 12Th Ave Rd, Nampa, ID and can be reached out via phone at 208-467-2545 and via fax at 208-466-3607.

Location: 109 12Th Ave Rd, Nampa, ID, 83686-5047
institution
Provider Profile Details
NPI Number
1093977647
Provider Name
Russell C. Pool, Dmd, Pa
Credential
Provider Entity Type
Organization
Address
109 12Th Ave Rd, Nampa, ID, 83686-5047
Phone Number
208-467-2545
Fax Number
208-466-3607
Provider Enumeration Date
06/25/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
66852 01 ID BLUE SHIELD OF IDAHO
institution
Provider Business Practice Location Address Details
Address
109 12Th Ave Rd
City
State
Zip
83686-5047
Phone Number
208-467-2545
Fax Number
208-466-3607
person
Provider Business Mailing Address Details
Address
109 12Th Ave Rd
City
State
Zip
83686-5047
Phone Number
208-467-2545
Fax Number
208-466-3607
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
D1687 (Idaho)
Definition
Definition to come...
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