| Legacy Family Dental Care Pllc | |
|
801 E Medical Ct Post Falls ID 83854-7298 | |
| (208) 773-1559 | |
| (208) 773-9959 |
| Full Name | Legacy Family Dental Care Pllc |
|---|---|
| Speciality | Dentist |
| Location | 801 E Medical Ct, Post Falls, Idaho |
| Authorized Official Name and Position | Christine Elaine Gibbon (OFFICE MANAGER) |
| Authorized Official Contact | 2087731559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Family Dental Care Pllc 801 E Medical Ct Post Falls ID 83854-7298 Ph: (208) 773-1559 | Legacy Family Dental Care Pllc 801 E Medical Ct Post Falls ID 83854-7298 Ph: (208) 773-1559 |
| NPI Number | 1598150286 |
|---|---|
| Provider Enumeration Date | 03/31/2015 |
| Last Update Date | 11/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598150286 | NPI | - | NPPES |
| 1093949133 | Other | ID | DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D4275 (Idaho) | Primary |
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