| Eagle Dental Partnership | |
|
577 E State St Eagle ID 83616-5938 | |
| (208) 342-4644 | |
| Not Available |
| Full Name | Eagle Dental Partnership |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 577 E State St, Eagle, Idaho |
| Authorized Official Name and Position | Karla Picciotti (OFFICE MANAGER) |
| Authorized Official Contact | 2088508348 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Dental Partnership 813 N Stilson Rd Boise ID 83703-5119 Ph: (208) 342-4644 | Eagle Dental Partnership 577 E State St Eagle ID 83616-5938 Ph: (208) 342-4644 |
| NPI Number | 1639732399 |
|---|---|
| Provider Enumeration Date | 04/18/2019 |
| Last Update Date | 04/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639732399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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