| Idaho Dental Professionals, P.c. | |
|
4701 S Eagle Rd. Ste. 100 Meridian ID 83642-7563 | |
| (208) 900-3350 | |
| (208) 900-3425 |
| Full Name | Idaho Dental Professionals, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4701 S Eagle Rd. Ste. 100, Meridian, Idaho |
| Authorized Official Name and Position | Cemyira Mcdougal (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2177648609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dental Professionals, P.c. 4701 S Eagle Rd. Ste. 100 Meridian ID 83642-7563 Ph: (208) 900-3350 | Idaho Dental Professionals, P.c. 4701 S Eagle Rd. Ste. 100 Meridian ID 83642-7563 Ph: (208) 900-3350 |
| NPI Number | 1982442448 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982442448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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