| Ikdo South Meridian Llc | |
|
3839 E Amity Rd Meridian ID 83642 | |
| (208) 999-4999 | |
| Not Available |
| Full Name | Ikdo South Meridian Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3839 E Amity Rd, Meridian, Idaho |
| Authorized Official Name and Position | Michael D Payne (OWNER) |
| Authorized Official Contact | 2088844466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ikdo South Meridian Llc 3289 N Towerbridge Way Meridian ID 83646-8347 Ph: (208) 884-4466 | Ikdo South Meridian Llc 3839 E Amity Rd Meridian ID 83642 Ph: (208) 999-4999 |
| NPI Number | 1174145684 |
|---|---|
| Provider Enumeration Date | 05/07/2020 |
| Last Update Date | 05/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174145684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
The Center For Sleep Apnea And Tmj Pa Dental Clinic Medicare: Medicare Enrolled Practice Location: 1718 S. Millennium Way, Meridian, ID 83642 Phone: 208-376-3600 Fax: 208-376-3616 | |
Willow Tree Dental Group Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 W Cherry Ln, Meridian, ID 83642 Phone: 208-472-7817 Fax: 208-345-2601 |