| Lorin E. Dixon, D.m.d. | |
|
205 Elm St Suite A Idaho Falls ID 83402-4054 | |
| (208) 524-2771 | |
| (208) 529-4277 |
| Full Name | Lorin E. Dixon, D.m.d. |
|---|---|
| Speciality | Dentist |
| Location | 205 Elm St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Lorin E Dixon (OWNER) |
| Authorized Official Contact | 2085242771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lorin E. Dixon, D.m.d. 205 Elm St Suite A Idaho Falls ID 83402-4054 Ph: (208) 524-2771 | Lorin E. Dixon, D.m.d. 205 Elm St Suite A Idaho Falls ID 83402-4054 Ph: (208) 524-2771 |
| NPI Number | 1962664383 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 06/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962664383 | NPI | - | NPPES |
| 001216200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D1975 (Idaho) | Primary |
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