| Children's Dentistry Of Idaho, Pllc | |
|
349 W Iowa Ave Nampa ID 83686-2856 | |
| (208) 467-5100 | |
| Not Available |
| Full Name | Children's Dentistry Of Idaho, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 349 W Iowa Ave, Nampa, Idaho |
| Authorized Official Name and Position | Jeffrey Bryson (OWNER/DENTIST) |
| Authorized Official Contact | 2084675100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dentistry Of Idaho, Pllc 349 W Iowa Ave Nampa ID 83686-2856 Ph: (208) 467-5100 | Children's Dentistry Of Idaho, Pllc 349 W Iowa Ave Nampa ID 83686-2856 Ph: (208) 467-5100 |
| NPI Number | 1689942849 |
|---|---|
| Provider Enumeration Date | 12/02/2011 |
| Last Update Date | 11/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689942849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D-4399-PD (Idaho) | Primary |
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Christian C. Cusimano Dds, Ms, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 W Iowa Ave, Nampa, ID 83686 Phone: 208-467-4362 Fax: 208-463-9080 | |
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