| Parkwest Dental Care | |
|
1088 N Skyline Dr Idaho Falls ID 83402-1726 | |
| (208) 524-0870 | |
| (208) 524-0873 |
| Full Name | Parkwest Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1088 N Skyline Dr, Idaho Falls, Idaho |
| Authorized Official Name and Position | Brett D. Jacobson (OWNER/DENTIST) |
| Authorized Official Contact | 2085240870 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkwest Dental Care 885 Pancheri Dr Idaho Falls ID 83402-3344 Ph: (208) 524-0870 | Parkwest Dental Care 1088 N Skyline Dr Idaho Falls ID 83402-1726 Ph: (208) 524-0870 |
| NPI Number | 1861666745 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 08/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861666745 | NPI | - | NPPES |
| 003552200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D-3203 (Idaho) | Primary |
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