| Blaisdell Dental Center, Pa | |
|
1916 Ellis Ave Caldwell ID 83605-4811 | |
| (208) 459-2376 | |
| (208) 459-1524 |
| Full Name | Blaisdell Dental Center, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1916 Ellis Ave, Caldwell, Idaho |
| Authorized Official Name and Position | John D Blaisdell (PRESIDENT) |
| Authorized Official Contact | 2084592376 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blaisdell Dental Center, Pa 1916 Ellis Ave Caldwell ID 83605-4811 Ph: (208) 459-2376 | Blaisdell Dental Center, Pa 1916 Ellis Ave Caldwell ID 83605-4811 Ph: (208) 459-2376 |
| NPI Number | 1881857753 |
|---|---|
| Provider Enumeration Date | 07/09/2008 |
| Last Update Date | 07/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881857753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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