| Idaho Oral & Maxillofacial Surgery, Pc | |
|
590 Falls Ave Twin Falls ID 83301-3314 | |
| (208) 733-1182 | |
| (208) 733-3341 |
| Full Name | Idaho Oral & Maxillofacial Surgery, Pc |
|---|---|
| Speciality | Dentist |
| Location | 590 Falls Ave, Twin Falls, Idaho |
| Authorized Official Name and Position | Timothy Ted Hopkins (OWNER) |
| Authorized Official Contact | 2087331182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Oral & Maxillofacial Surgery, Pc 590 Falls Ave Twin Falls ID 83301-3314 Ph: (208) 733-1182 | Idaho Oral & Maxillofacial Surgery, Pc 590 Falls Ave Twin Falls ID 83301-3314 Ph: (208) 733-1182 |
| NPI Number | 1588868442 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 07/25/2014 |
| Medicare PECOS PAC ID | 5890894224 |
|---|---|
| Medicare Enrollment ID | O20070625000748 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588868442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | D3944-OS (Idaho) | Primary |
| Provider Name | Timothy T Hopkins |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1376689646 PECOS PAC ID: 4981703311 Enrollment ID: I20070625000743 |
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