IDAHO CENTER FOR ORAL AND FACIAL SURGERY
Organization (NPI-2)
Active
Clinic/Center, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1558675298- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 177 VISTA DR, POCATELLO, ID, 832015824
- Phone
- (208) 232-0232
- Fax
- (208) 232-2044
Specialties & Taxonomies
Clinic/Center, Oral and Maxillofacial Surgery
Primary License: ID #D-4276-OS