FAMILY DENTAL OF BLACKFOOT LLC
Organization (NPI-2)
Active
Dentist
Provider Information
- NPI Number
1205208162- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 2407 TEEPLES DR, BLACKFOOT, ID, 832215877
- Phone
- (208) 782-0242
- Fax
- (208) 782-1160
Specialties & Taxonomies
Dentist
License: ID #D-3830
Dentist
Primary License: ID #D-3614