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Idaho State University
General Practice Dentistry in Pocatello, Idaho
NPI 1851516256

Idaho State University is a General Practice Dentistry based in Pocatello, ID and is specialized in General Practice. Idaho State University practices in Pocatello, ID. The NPI Number for Idaho State University is 1851516256 and holds a License No. (Idaho).

The current practice location address for Idaho State University is 465 Memorial Dr., Pocatello, ID and can be reached out via phone at 208-282-6000 and via fax at 208-282-4950.

Location: 465 Memorial Dr., Pocatello, ID, 83209-8088
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1851516256
Provider Name
Idaho State University
Credential
Provider Entity Type
Organization
Address
465 Memorial Dr., Pocatello, ID, 83209-8088
Phone Number
208-282-6000
Fax Number
208-282-4950
Provider Enumeration Date
04/13/2007
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
181764 05 ID
8057101 05 ID
institution
Provider Business Practice Location Address Details
Address
465 Memorial Dr.
City
Pocatello
State
Idaho
Zip
83209-8088
Phone Number
208-282-6000
Fax Number
208-282-4950
person
Provider Business Mailing Address Details
Address
465 Memorial Dr.
City
Pocatello
State
Idaho
Zip
83209-8088
Phone Number
208-282-6000
Fax Number
208-282-4950
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
(Idaho)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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