| Dental Health Center | |
|
56 Professional Plz Rexburg ID 83440-2047 | |
| (208) 356-9262 | |
| (208) 356-4804 |
| Full Name | Dental Health Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 56 Professional Plz, Rexburg, Idaho |
| Authorized Official Name and Position | Douglas J Smith (OWNER-DENTIST) |
| Authorized Official Contact | 2083569262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Health Center 56 Professional Plz Rexburg ID 83440-2047 Ph: (208) 356-9262 | Dental Health Center 56 Professional Plz Rexburg ID 83440-2047 Ph: (208) 356-9262 |
| NPI Number | 1962664458 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 06/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962664458 | NPI | - | NPPES |
| 001193200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D1433 (Idaho) | Primary |
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