Machen Family Dentistry Pc | |
3500 Potomac Way Suite 200 Idaho Falls ID 83404-4974 | |
(208) 552-0775 | |
Not Available |
Full Name | Machen Family Dentistry Pc |
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Speciality | Dentist |
Location | 3500 Potomac Way, Idaho Falls, Idaho |
Authorized Official Name and Position | Esther B Machen (PRESIDENT) |
Authorized Official Contact | 2085520775 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Machen Family Dentistry Pc 3500 Potomac Way Suite 200 Idaho Falls ID 83404-4974 Ph: (208) 552-0775 | Machen Family Dentistry Pc 3500 Potomac Way Suite 200 Idaho Falls ID 83404-4974 Ph: (208) 552-0775 |
NPI Number | 1679860829 |
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Provider Enumeration Date | 07/07/2011 |
Last Update Date | 10/14/2016 |
Medicare PECOS PAC ID | 3476806696 |
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Medicare Enrollment ID | O20181105001992 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679860829 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | D-4356 (Idaho) | Primary |
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