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Idaho Dental Anesthesia Pllc
Dentist Anesthesiologist in Meridian, Idaho
NPI 1629470141

Idaho Dental Anesthesia Pllc is a Dentist Anesthesiologist based in Meridian, ID and is specialized in Dentist Anesthesiologist. Idaho Dental Anesthesia Pllc practices in Meridian, ID. The NPI Number for Idaho Dental Anesthesia Pllc is 1629470141 and holds a License No. D-4613 (Idaho).

The current practice location address for Idaho Dental Anesthesia Pllc is 37 W Archerfield St Ste 100, Meridian, ID and can be reached out via phone at 208-391-2894.

Location: 37 W Archerfield St Ste 100, Meridian, ID, 83646-6587
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629470141
Provider Name
Idaho Dental Anesthesia Pllc
Credential
Provider Entity Type
Organization
Address
37 W Archerfield St Ste 100, Meridian, ID, 83646-6587
Phone Number
208-391-2894
Fax Number
Provider Enumeration Date
09/17/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
37 W Archerfield St Ste 100
City
Meridian
State
Idaho
Zip
83646-6587
Phone Number
208-391-2894
Fax Number
person
Provider Business Mailing Address Details
Address
37 W Archerfield St Ste 100
City
Meridian
State
Idaho
Zip
83646-6587
Phone Number
208-391-2894
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Dentist Anesthesiologist
Taxonomy
1223D0004X
License No.
D-4613 (Idaho)
Definition
A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
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