Oneida Family Dental Llc | |
150 S Main St Apt 16 Malad City ID 83252-1405 | |
(208) 904-3614 | |
Not Available |
Full Name | Oneida Family Dental Llc |
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Speciality | Dentist - General Practice |
Location | 150 S Main St Apt 16, Malad City, Idaho |
Authorized Official Name and Position | Shenell Clark (OFFICE MANAGER) |
Authorized Official Contact | 2089043614 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Oneida Family Dental Llc 150 S Main St Apt 16 Malad City ID 83252-1405 Ph: () - | Oneida Family Dental Llc 150 S Main St Apt 16 Malad City ID 83252-1405 Ph: (208) 904-3614 |
NPI Number | 1316454333 |
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Provider Enumeration Date | 12/29/2017 |
Last Update Date | 12/29/2017 |
Identifier | Type | State | Issuer |
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1316454333 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | D4484 (Idaho) | Primary |
Malad Valley Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 185 S 300 E, Malad City, ID 83252 Phone: 208-766-2204 Fax: 208-766-2204 |