institution
Idaho Innovative Dentistry, Pllc
Dental Clinic/Center in Eagle, Idaho
NPI 1649620139

Idaho Innovative Dentistry, Pllc is a Dental Clinic/Center based in Eagle, ID and is specialized in Dental. Idaho Innovative Dentistry, Pllc practices in Eagle, ID. The NPI Number for Idaho Innovative Dentistry, Pllc is 1649620139 and holds a License No. D-4002 (Idaho).

The current practice location address for Idaho Innovative Dentistry, Pllc is 467 S Rivershore Ln, Eagle, ID and can be reached out via phone at 208-938-1247.

Location: 467 S Rivershore Ln, Eagle, ID, 83616
institution
Provider Profile Details
NPI Number
1649620139
Provider Name
Idaho Innovative Dentistry, Pllc
Credential
Provider Entity Type
Organization
Address
467 S Rivershore Ln, Eagle, ID, 83616
Phone Number
208-938-1247
Fax Number
Provider Enumeration Date
06/15/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
467 S Rivershore Ln
City
State
Zip
83616-4978
Phone Number
208-938-1247
Fax Number
person
Provider Business Mailing Address Details
Address
467 S Rivershore Ln
City
State
Zip
83616-4978
Phone Number
208-938-1247
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
D-4002 (Idaho)
Definition
Definition to come...
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