institution
Moulton Periodontics, Pllc
Dental Clinic/Center in Idaho Falls, Idaho
NPI 1104085935

Moulton Periodontics, Pllc is a Dental Clinic/Center based in Idaho Falls, ID and is specialized in Dental. Moulton Periodontics, Pllc practices in Idaho Falls, ID. The NPI Number for Moulton Periodontics, Pllc is 1104085935 and holds a License No. D-4093-PE (Idaho).

The current practice location address for Moulton Periodontics, Pllc is 2375 E Sunnyside Rd, Idaho Falls, ID and can be reached out via phone at 208-522-6683 and via fax at 208-552-3085.

Location: 2375 E Sunnyside Rd, Idaho Falls, ID, 83404-8280
institution
Provider Profile Details
NPI Number
1104085935
Provider Name
Moulton Periodontics, Pllc
Credential
Provider Entity Type
Organization
Address
2375 E Sunnyside Rd, Idaho Falls, ID, 83404-8280
Phone Number
208-522-6683
Fax Number
208-552-3085
Provider Enumeration Date
06/06/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2375 E Sunnyside Rd
City
State
Zip
83404-8280
Phone Number
208-522-6683
Fax Number
208-552-3085
person
Provider Business Mailing Address Details
Address
2375 E Sunnyside Rd
City
State
Zip
83404-8280
Phone Number
208-522-6683
Fax Number
208-552-3085
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
D-4093-PE (Idaho)
Definition
Definition to come...
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