| Legacy Smiles Family Dental, Pllc | |
|
1180 N Olive Ave Meridian ID 83642-5920 | |
| (208) 888-3311 | |
| (208) 888-1691 |
| Full Name | Legacy Smiles Family Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1180 N Olive Ave, Meridian, Idaho |
| Authorized Official Name and Position | Brad J Williams (PARTNER) |
| Authorized Official Contact | 2088883311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Smiles Family Dental, Pllc 1180 N Olive Ave Meridian ID 83642-5920 Ph: (208) 888-3311 | Legacy Smiles Family Dental, Pllc 1180 N Olive Ave Meridian ID 83642-5920 Ph: (208) 888-3311 |
| NPI Number | 1275646259 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 05/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275646259 | NPI | - | NPPES |
| 002799500 | Medicaid | ID | |
| 806233700 | Medicaid | ID | |
| 002799600 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3220 (Idaho) | Primary |
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 |