| Cherry Lane Kids Dentistry | |
|
1558 N Crestmont Dr Ste A Meridian ID 83642-2194 | |
| (208) 580-7091 | |
| (208) 587-2624 |
| Full Name | Cherry Lane Kids Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1558 N Crestmont Dr Ste A, Meridian, Idaho |
| Authorized Official Name and Position | Rhonda Marie Elquist (REGIONAL OPERATIONS MANAGER) |
| Authorized Official Contact | 2085807091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cherry Lane Kids Dentistry 121 Mountain View Dr Nampa ID 83686-8867 Ph: (208) 760-0335 | Cherry Lane Kids Dentistry 1558 N Crestmont Dr Ste A Meridian ID 83642-2194 Ph: (208) 580-7091 |
| NPI Number | 1902325749 |
|---|---|
| Provider Enumeration Date | 09/13/2017 |
| Last Update Date | 09/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902325749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D-4186-PD (Idaho) | Primary |
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