| Couch Dental Care | |
|
2110 E 25th St Idaho Falls ID 83404-6475 | |
| (208) 552-5520 | |
| (208) 552-5522 |
| Full Name | Couch Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2110 E 25th St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Val Aleta Swenson (CLINICAL MANAGER) |
| Authorized Official Contact | 2085525520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Couch Dental Care 2110 E 25th St Idaho Falls ID 83404-6475 Ph: (208) 552-5520 | Couch Dental Care 2110 E 25th St Idaho Falls ID 83404-6475 Ph: (208) 552-5520 |
| NPI Number | 1538596424 |
|---|---|
| Provider Enumeration Date | 10/09/2013 |
| Last Update Date | 10/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538596424 | NPI | - | NPPES |
| D1303 | Other | ID | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D1303 (Idaho) | Primary |
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