| Innovative Sleep & Tmj Center Pllc | |
|
1720 W Mcmillan Rd Meridian ID 83646-6892 | |
| (208) 216-6110 | |
| Not Available |
| Full Name | Innovative Sleep & Tmj Center Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1720 W Mcmillan Rd, Meridian, Idaho |
| Authorized Official Name and Position | Randall B Smith (MANAGER) |
| Authorized Official Contact | 2088706288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Sleep & Tmj Center Pllc 1720 W Mcmillan Rd Meridian ID 83646-6892 Ph: (208) 216-6110 | Innovative Sleep & Tmj Center Pllc 1720 W Mcmillan Rd Meridian ID 83646-6892 Ph: (208) 216-6110 |
| NPI Number | 1124892773 |
|---|---|
| Provider Enumeration Date | 11/14/2023 |
| Last Update Date | 11/14/2023 |
| Medicare PECOS PAC ID | 4688018146 |
|---|---|
| Medicare Enrollment ID | O20240223000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124892773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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