| Hayden Lake Family Dental Pllc | |
|
8636 N Wayne Dr Hayden ID 83835-5084 | |
| (208) 762-1555 | |
| Not Available |
| Full Name | Hayden Lake Family Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8636 N Wayne Dr, Hayden, Idaho |
| Authorized Official Name and Position | Chase Davis (MEMBER) |
| Authorized Official Contact | 4809178400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hayden Lake Family Dental Pllc 3010 E Fruitvale Ave Gilbert AZ 85297-5261 Ph: (480) 341-0095 | Hayden Lake Family Dental Pllc 8636 N Wayne Dr Hayden ID 83835-5084 Ph: (208) 762-1555 |
| NPI Number | 1942046651 |
|---|---|
| Provider Enumeration Date | 07/02/2024 |
| Last Update Date | 07/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942046651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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