| Modern Smiles Pocatello Pc | |
|
1800 Flandro Dr Ste 340 Pocatello ID 83202-4944 | |
| (208) 238-1900 | |
| Not Available |
| Full Name | Modern Smiles Pocatello Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1800 Flandro Dr Ste 340, Pocatello, Idaho |
| Authorized Official Name and Position | Stephanie Frank (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5095706879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Smiles Pocatello Pc 1800 Flandro Dr Ste 340 Pocatello ID 83202-4944 Ph: () - | Modern Smiles Pocatello Pc 1800 Flandro Dr Ste 340 Pocatello ID 83202-4944 Ph: (208) 238-1900 |
| NPI Number | 1609592435 |
|---|---|
| Provider Enumeration Date | 10/13/2022 |
| Last Update Date | 02/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609592435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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