Idaho City Family Dentistry | |
219 Main Street Idaho City ID 83631 | |
(208) 392-9900 | |
(208) 392-9933 |
Full Name | Idaho City Family Dentistry |
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Speciality | Dentist - General Practice |
Location | 219 Main Street, Idaho City, Idaho |
Authorized Official Name and Position | Shane D Vania (DENTIST) |
Authorized Official Contact | 2083929900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Idaho City Family Dentistry 219 Main Street Po Box 1010 Idaho City ID 83631-1010 Ph: (208) 392-9900 | Idaho City Family Dentistry 219 Main Street Idaho City ID 83631 Ph: (208) 392-9900 |
NPI Number | 1992964597 |
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Provider Enumeration Date | 06/09/2008 |
Last Update Date | 06/09/2008 |
Identifier | Type | State | Issuer |
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1992964597 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |