| Allied Dental Clinic, Pc | |
|
1246 Yellowstone Ave Ste B3 Pocatello ID 83201-4372 | |
| (208) 237-0563 | |
| Not Available |
| Full Name | Allied Dental Clinic, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1246 Yellowstone Ave Ste B3, Pocatello, Idaho |
| Authorized Official Name and Position | Randall C Snow (OWNER) |
| Authorized Official Contact | 2082370563 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Allied Dental Clinic, Pc 1246 Yellowstone Ave Ste B3 Pocatello ID 83201-4372 Ph: (208) 237-0563 | Allied Dental Clinic, Pc 1246 Yellowstone Ave Ste B3 Pocatello ID 83201-4372 Ph: (208) 237-0563 |
| NPI Number | 1790999407 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790999407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3171 (Idaho) | Primary |
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