| Idaho Falls Dental Group | |
|
2300 E 17th St Idaho Falls ID 83404-6504 | |
| (208) 525-8383 | |
| (208) 523-6419 |
| Full Name | Idaho Falls Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 2300 E 17th St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Tracy Larsen (OFFICE MANAGER) |
| Authorized Official Contact | 2085258383 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Falls Dental Group Po Box 2046 Idaho Falls ID 83403-2046 Ph: (208) 525-8383 | Idaho Falls Dental Group 2300 E 17th St Idaho Falls ID 83404-6504 Ph: (208) 525-8383 |
| NPI Number | 1497803696 |
|---|---|
| Provider Enumeration Date | 01/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497803696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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