| Health West Community Dental | |
|
1000 N 8th Ave Pocatello ID 83201-5757 | |
| (208) 232-3369 | |
| (208) 776-5016 |
| Full Name | Health West Community Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1000 N 8th Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Mindy Benedetti (CEO) |
| Authorized Official Contact | 2082327862 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health West Community Dental Po Box 2377 Pocatello ID 83206-2377 Ph: (208) 232-7862 | Health West Community Dental 1000 N 8th Ave Pocatello ID 83201-5757 Ph: (208) 232-3369 |
| NPI Number | 1346658515 |
|---|---|
| Provider Enumeration Date | 07/31/2014 |
| Last Update Date | 12/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346658515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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