| Magic Valley Family Dental | |
|
115 W 100 S Rupert ID 83350-9125 | |
| (208) 436-4532 | |
| Not Available |
| Full Name | Magic Valley Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 115 W 100 S, Rupert, Idaho |
| Authorized Official Name and Position | Denise J Mallory (OFFICE MANAGER) |
| Authorized Official Contact | 2084364532 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magic Valley Family Dental 115 W 100 S Rupert ID 83350-9125 Ph: (208) 436-4532 | Magic Valley Family Dental 115 W 100 S Rupert ID 83350-9125 Ph: (208) 436-4532 |
| NPI Number | 1477723955 |
|---|---|
| Provider Enumeration Date | 03/11/2008 |
| Last Update Date | 03/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477723955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3903 (Idaho) | Primary |
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