| Foothills Dental Care | |
|
2205 Channing Way Suite A Idaho Falls ID 83404-8016 | |
| (208) 529-4484 | |
| (208) 523-4441 |
| Full Name | Foothills Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2205 Channing Way, Idaho Falls, Idaho |
| Authorized Official Name and Position | Wayne Bernell Murdock (OWNER/PARTNER) |
| Authorized Official Contact | 2085294484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothills Dental Care 3955 Georgia Ln Ammon ID 83406-7812 Ph: (208) 529-0868 | Foothills Dental Care 2205 Channing Way Suite A Idaho Falls ID 83404-8016 Ph: (208) 529-4484 |
| NPI Number | 1275619090 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275619090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D1719 (Idaho) | Primary |
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