| Magic Valley Dental Anesthesia Pllc | |
|
1411 Falls Ave E Ste 1000c Twin Falls ID 83301-3459 | |
| (208) 734-7415 | |
| Not Available |
| Full Name | Magic Valley Dental Anesthesia Pllc |
|---|---|
| Speciality | Dentist - Dentist Anesthesiologist |
| Location | 1411 Falls Ave E Ste 1000c, Twin Falls, Idaho |
| Authorized Official Name and Position | Ryan Judd (OWNER) |
| Authorized Official Contact | 5036799797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magic Valley Dental Anesthesia Pllc 3245 S Brandenberg Ave Eagle ID 83616-4413 Ph: () - | Magic Valley Dental Anesthesia Pllc 1411 Falls Ave E Ste 1000c Twin Falls ID 83301-3459 Ph: (208) 734-7415 |
| NPI Number | 1346824422 |
|---|---|
| Provider Enumeration Date | 05/05/2021 |
| Last Update Date | 05/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346824422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0004X | Dentist - Dentist Anesthesiologist | (* (Not Available)) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
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