| Desert Valley Dentistry | |
|
716 Yellowstone Ave Pocatello ID 83201-4407 | |
| (208) 478-1295 | |
| (208) 232-5490 |
| Full Name | Desert Valley Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 716 Yellowstone Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Larry Walden Bybee (DENTIST) |
| Authorized Official Contact | 2084781295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Valley Dentistry 716 Yellowstone Ave Pocatello ID 83201-4407 Ph: (208) 478-1295 | Desert Valley Dentistry 716 Yellowstone Ave Pocatello ID 83201-4407 Ph: (208) 478-1295 |
| NPI Number | 1083143739 |
|---|---|
| Provider Enumeration Date | 06/07/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083143739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D1664 (Idaho) | Primary |
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