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Brock Coletti
Pediatric Dentist in Meridian, Idaho
NPI 1720447097

Brock Coletti is a Pediatric Dentist based in Meridian, ID and is specialized in Pediatric Dentistry. Brock Coletti practices in Meridian, ID. The NPI Number for Brock Coletti is 1720447097 and holds a License No. (Idaho).

The current practice location address for Brock Coletti is 3235 N Towerbridge Way Ste 200, Meridian, ID and can be reached out via phone at 208-888-7711 and via fax at 208-888-3089.

Location: 3235 N Towerbridge Way Ste 200, Meridian, ID, 83646-5721
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720447097
Provider Name
Brock Coletti
Credential
Provider Entity Type
Individual
Gender
Male
Address
3235 N Towerbridge Way Ste 200, Meridian, ID, 83646-5721
Phone Number
208-888-7711
Fax Number
208-888-3089
Provider Enumeration Date
02/15/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3235 N Towerbridge Way Ste 200
City
Meridian
State
Idaho
Zip
83646-5721
Phone Number
208-888-7711
Fax Number
208-888-3089
person
Provider Business Mailing Address Details
Address
3235 N Towerbridge Way Ste 200
City
Meridian
State
Idaho
Zip
83646-5721
Phone Number
208-888-7711
Fax Number
208-888-3089
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
D-4928 (Idaho)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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