| North College Dental, Pc | |
|
1411 Fillmore St Suite 601 Twin Falls ID 83301-3343 | |
| (208) 734-2300 | |
| (208) 736-7214 |
| Full Name | North College Dental, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1411 Fillmore St, Twin Falls, Idaho |
| Authorized Official Name and Position | Marni Peterson (OFFICE MANAGER) |
| Authorized Official Contact | 2087342300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North College Dental, Pc 1411 Fillmore St Suite 601 Twin Falls ID 83301-3343 Ph: (208) 734-2300 | North College Dental, Pc 1411 Fillmore St Suite 601 Twin Falls ID 83301-3343 Ph: (208) 734-2300 |
| NPI Number | 1336313683 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 04/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336313683 | NPI | - | NPPES |
| 9201590 | Other | ID | IDAHO SMILES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D1788 (Idaho) | Primary |
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