| Olympus Family Dental | |
|
1598 Delphic Way Ste B Pocatello ID 83201-2200 | |
| (208) 237-4357 | |
| (208) 237-1418 |
| Full Name | Olympus Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1598 Delphic Way Ste B, Pocatello, Idaho |
| Authorized Official Name and Position | Richard E Fellows (OWNER) |
| Authorized Official Contact | 2082374357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olympus Family Dental 1598 Delphic Way Ste B Pocatello ID 83201-2200 Ph: (208) 237-4357 | Olympus Family Dental 1598 Delphic Way Ste B Pocatello ID 83201-2200 Ph: (208) 237-4357 |
| NPI Number | 1306005236 |
|---|---|
| Provider Enumeration Date | 06/05/2008 |
| Last Update Date | 06/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306005236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3406 (Idaho) | Primary |
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