| Leavitt Orthodontics | |
|
1455 Bench Rd Ste A Pocatello ID 83201-5084 | |
| (208) 237-3330 | |
| Not Available |
| Full Name | Leavitt Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1455 Bench Rd Ste A, Pocatello, Idaho |
| Authorized Official Name and Position | Tyler Leavitt (OWNER/DENTIST) |
| Authorized Official Contact | 2082405219 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leavitt Orthodontics 1455 Bench Rd Ste A Pocatello ID 83201-5084 Ph: (208) 237-3330 | Leavitt Orthodontics 1455 Bench Rd Ste A Pocatello ID 83201-5084 Ph: (208) 237-3330 |
| NPI Number | 1821866682 |
|---|---|
| Provider Enumeration Date | 12/12/2023 |
| Last Update Date | 12/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821866682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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