| Bingham Endodontics, Pllc | |
|
610 W. Broadway Ave Jackson WY 83001 | |
| (208) 227-0382 | |
| (208) 227-0384 |
| Full Name | Bingham Endodontics, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 610 W. Broadway Ave, Jackson, Wyoming |
| Authorized Official Name and Position | Lynda Del Rio (OFFICE MANAGER) |
| Authorized Official Contact | 2087472651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bingham Endodontics, Pllc 3387 Merlin Dr Idaho Falls ID 83404-7405 Ph: () - | Bingham Endodontics, Pllc 610 W. Broadway Ave Jackson WY 83001 Ph: (208) 227-0382 |
| NPI Number | 1972863207 |
|---|---|
| Provider Enumeration Date | 05/21/2012 |
| Last Update Date | 05/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972863207 | NPI | - | NPPES |
| 1780859223 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1191 (Wyoming) | Primary |
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