| Children's Dentistry Of Twin Falls | |
|
1186 Eastland Dr N Suite B Twin Falls ID 83301-8973 | |
| (208) 733-9331 | |
| (208) 732-1222 |
| Full Name | Children's Dentistry Of Twin Falls |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1186 Eastland Dr N, Twin Falls, Idaho |
| Authorized Official Name and Position | Dallin Clifford Young (PRESIDENT) |
| Authorized Official Contact | 2087339331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dentistry Of Twin Falls 1186 Eastland Dr N Suite B Twin Falls ID 83301-8973 Ph: (208) 733-9331 | Children's Dentistry Of Twin Falls 1186 Eastland Dr N Suite B Twin Falls ID 83301-8973 Ph: (208) 733-9331 |
| NPI Number | 1417119330 |
|---|---|
| Provider Enumeration Date | 07/01/2008 |
| Last Update Date | 07/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417119330 | NPI | - | NPPES |
| 807215900 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D-3874-PD (Idaho) | Primary |
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