| Candid Idaho, P.c. | |
|
800 W Main St Ste 1460 Boise ID 83702-5983 | |
| (860) 481-7631 | |
| Not Available |
| Full Name | Candid Idaho, P.c. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 800 W Main St Ste 1460, Boise, Idaho |
| Authorized Official Name and Position | Thomas Shannon (DDS) |
| Authorized Official Contact | 8604817631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Candid Idaho, P.c. 800 W Main St Ste 1460 Boise ID 83702-5983 Ph: (860) 481-7631 | Candid Idaho, P.c. 800 W Main St Ste 1460 Boise ID 83702-5983 Ph: (860) 481-7631 |
| NPI Number | 1659988749 |
|---|---|
| Provider Enumeration Date | 09/23/2020 |
| Last Update Date | 09/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659988749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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