| Idaho Pediatric Dentistry | |
|
4401 E Flamingo Ave Nampa ID 83687-3113 | |
| (208) 461-5459 | |
| (208) 461-6023 |
| Full Name | Idaho Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4401 E Flamingo Ave, Nampa, Idaho |
| Authorized Official Name and Position | Christopher K Loveland (OWNER) |
| Authorized Official Contact | 2084615459 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Pediatric Dentistry 4401 E Flamingo Ave Nampa ID 83687-3113 Ph: (208) 461-5459 | Idaho Pediatric Dentistry 4401 E Flamingo Ave Nampa ID 83687-3113 Ph: (208) 461-5459 |
| NPI Number | 1467697177 |
|---|---|
| Provider Enumeration Date | 12/09/2008 |
| Last Update Date | 12/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467697177 | NPI | - | NPPES |
| 807511400 | Medicaid | ID | |
| 808185200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D3936 (Idaho) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D3908 (Idaho) | Secondary |
Southridge Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2811 12th Ave Rd, Nampa, ID 83686 Phone: 208-466-2458 Fax: 208-465-6303 | |
Dba Ronald J. Albright Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 11th St S, Nampa, ID 83651 Phone: 208-463-1800 | |
Jmj Holding Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 914 12th Ave Rd Ste 102, Nampa, ID 83686 Phone: 208-996-3010 | |
Onsite Dental, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 524 E Fujii Dr, Nampa, ID 83686 Phone: 844-667-4834 Fax: 208-376-3616 | |
Christian C. Cusimano Dds, Ms, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 W Iowa Ave, Nampa, ID 83686 Phone: 208-467-4362 Fax: 208-463-9080 | |
Russell C. Pool, Dmd, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 12th Ave Rd, Nampa, ID 83686 Phone: 208-467-2545 Fax: 208-466-3607 | |
Scott R Gardner Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2065 12th Ave Rd, Nampa, ID 83686 Phone: 208-466-3239 |