| Children's Dentistry Of Pocatello | |
|
425 E Alameda Rd Pocatello ID 83201-3609 | |
| (208) 238-1165 | |
| (208) 238-1241 |
| Full Name | Children's Dentistry Of Pocatello |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 425 E Alameda Rd, Pocatello, Idaho |
| Authorized Official Name and Position | Ross Hugues (OWNER) |
| Authorized Official Contact | 2082381165 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dentistry Of Pocatello 425 E Alameda Rd Pocatello ID 83201-3609 Ph: (208) 238-1165 | Children's Dentistry Of Pocatello 425 E Alameda Rd Pocatello ID 83201-3609 Ph: (208) 238-1165 |
| NPI Number | 1255730370 |
|---|---|
| Provider Enumeration Date | 08/14/2014 |
| Last Update Date | 08/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255730370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D3679PD (Idaho) | Primary |
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