LIGHTHOUSE DENTAL GROUP
Organization (NPI-2)
Active
Dentist
Provider Information
- NPI Number
1174631287- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1177 N EAGLE RD, EAGLE, ID, 83616
- Phone
- (208) 939-3010
- Fax
- (208) 939-3027
Specialties & Taxonomies
Dentist
License: ID #Drug ID #BH6399857
Dentist
License: ID #D3878
Dentist
License: ID #Drug ID #BJ9304623
Dentist
Primary License: ID #D3380