person
Mr. Fred Elmer Giovanini, LD
Denturist in Idaho Falls, Idaho
NPI 1386875268

Fred Elmer Giovanini is a Denturist based in Idaho Falls, ID. Fred Elmer Giovanini practices in Idaho Falls, ID and has the professional credentials of LD. The NPI Number for Fred Elmer Giovanini is 1386875268 and holds a License No. LD35 (Idaho).

The current practice location address for Fred Elmer Giovanini is 505 1St Street, Suite A, Idaho Falls, ID and can be reached out via phone at 208-525-6002 and via fax at 208-232-2558. You can also correspond with Fred Elmer Giovanini through the mailing address at 505 1ST ST, IDAHO FALLS, ID - 83401-3929 (mailing address contact number: 208-525-6002).

Location: 505 1St Street, Suite A, Idaho Falls, ID, 83401-3929
person
Provider Profile Details
NPI Number
1386875268
Provider Name
Fred Elmer Giovanini
Credential
LD
Provider Entity Type
Individual
Gender
Male
Address
505 1St Street, Suite A, Idaho Falls, ID, 83401-3929
Phone Number
208-525-6002
Fax Number
208-232-2558
Provider Enumeration Date
07/27/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000010009728 01 ID BLUE SHIELD OF IDAHO
753354100000 01 WA PREMERA BLUE CROSS
GD203 01 ID BLUE CROSS OF IDAHO
1650686 01 PA UNITED CONCORDIA
0005553418 01 KY AETNA
0041 01 ID DELTA DENTAL OF IDAHO
002725400 05 ID
institution
Provider Business Practice Location Address Details
Address
505 1St Street, Suite A
City
State
Zip
83401
Phone Number
208-525-6002
Fax Number
208-232-2558
person
Provider Business Mailing Address Details
Address
505 1St Street, Suite A
City
State
Zip
83401
Phone Number
208-525-6002
Fax Number
208-232-2558
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
License No.
LD35 (Idaho)
Definition
Definition to come.
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