Middle Creek Dental | |
155 S Midland Blvd Nampa ID 83686-2601 | |
(208) 466-7424 | |
(208) 466-7512 |
Full Name | Middle Creek Dental |
---|---|
Speciality | Dentist - General Practice |
Location | 155 S Midland Blvd, Nampa, Idaho |
Authorized Official Name and Position | Shaun Christensen (OWNER / DENTIST) |
Authorized Official Contact | 2084667424 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Middle Creek Dental 155 S Midland Blvd Nampa ID 83686-2601 Ph: (208) 466-7424 | Middle Creek Dental 155 S Midland Blvd Nampa ID 83686-2601 Ph: (208) 466-7424 |
NPI Number | 1790899409 |
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Provider Enumeration Date | 08/18/2006 |
Last Update Date | 09/20/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790899409 | NPI | - | NPPES |
806452800 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | D3588 (Idaho) | Primary |
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Christian C. Cusimano Dds, Ms, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 W Iowa Ave, Nampa, ID 83686 Phone: 208-467-4362 Fax: 208-463-9080 | |
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