| Millennium Family Dental - Meridian Pllc | |
|
1848 Millenium Way Meridian ID 83642 | |
| (208) 888-2026 | |
| (208) 888-2094 |
| Full Name | Millennium Family Dental - Meridian Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1848 Millenium Way, Meridian, Idaho |
| Authorized Official Name and Position | Randall B Smith (OWNER) |
| Authorized Official Contact | 2088882026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Family Dental - Meridian Pllc 1848 Millenium Way Meridian ID 83642 Ph: (208) 888-2026 | Millennium Family Dental - Meridian Pllc 1848 Millenium Way Meridian ID 83642 Ph: (208) 888-2026 |
| NPI Number | 1689773525 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 01/26/2022 |
| Medicare PECOS PAC ID | 3274931431 |
|---|---|
| Medicare Enrollment ID | O20211004000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689773525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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