Avondale Dental Center, L.l.c. is a medicare enrolled dental clinic (Dentist) in Hayden Lake, Idaho. The current practice location for Avondale Dental Center, L.l.c. is 1683 E. Miles Ave., Hayden Lake, Idaho. For appointments, you can reach them via phone at
(208) 772-4066. The mailing address for Avondale Dental Center, L.l.c. is 1683 E Miles Ave, Hayden Lake, Idaho and phone number is (208) 772-4066.
Avondale Dental Center, L.l.c. is licensed to practice in Idaho (license number D1572). The clinic also participates in the medicare program and its
NPI number is 1174758619. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(208) 772-4066.
Dental Care Clinic Profile
| Full Name | Avondale Dental Center, L.l.c. |
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| Speciality | Dentist |
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| Location | 1683 E. Miles Ave., Hayden Lake, Idaho |
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| Authorized Official Name and Position | James A Robson (OWNER) |
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| Authorized Official Contact | 2087724066 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Avondale Dental Center, L.l.c.
1683 E Miles Ave
Hayden Lake
ID 83835-9109
Ph: (208) 772-4066 | Avondale Dental Center, L.l.c.
1683 E. Miles Ave.
Hayden Lake
ID 83835-9109
Ph: (208) 772-4066 |
NPI Details:
| NPI Number | 1174758619 |
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| Provider Enumeration Date | 05/28/2009 |
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| Last Update Date | 05/28/2009 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 0840591251 |
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| Medicare Enrollment ID | O20151209000040 |
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Medical Identifiers
Medical identifiers for Avondale Dental Center, L.l.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1174758619 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | D1572 (Idaho) | Primary |
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