| Michael T Mchugh D.d.s., Pa | |
|
1246 Yellowstone Ave Ste. D3 Pocatello ID 83201-4374 | |
| (208) 238-0125 | |
| (208) 478-2200 |
| Full Name | Michael T Mchugh D.d.s., Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1246 Yellowstone Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Michael T Mchugh (PRESIDENT) |
| Authorized Official Contact | 2082380125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael T Mchugh D.d.s., Pa 1246 Yellowstone Ave Ste. D3 Pocatello ID 83201-4374 Ph: (208) 238-0125 | Michael T Mchugh D.d.s., Pa 1246 Yellowstone Ave Ste. D3 Pocatello ID 83201-4374 Ph: (208) 238-0125 |
| NPI Number | 1891918603 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 09/07/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891918603 | NPI | - | NPPES |
| 679416 | Other | UNITED CONCORDIA | |
| 68007 | Other | ID | BLUE CROSS OF IDAHO |
| 123544 | Other | DESERET MUTUAL | |
| 000010009646 | Other | ID | BLUE SHIELD OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D1755 (Idaho) | Primary |
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