| Rainbow Dental Clinic Llc | |
|
418 W Cameron Ave Kellogg ID 83837-2111 | |
| (208) 784-5801 | |
| (208) 783-6011 |
| Full Name | Rainbow Dental Clinic Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 418 W Cameron Ave, Kellogg, Idaho |
| Authorized Official Name and Position | Steven Joseph Rinaldi (GENERAL DENTIST/ OWNER) |
| Authorized Official Contact | 2087845801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rainbow Dental Clinic Llc 418 W Cameron Ave Kellogg ID 83837-2111 Ph: (208) 784-5801 | Rainbow Dental Clinic Llc 418 W Cameron Ave Kellogg ID 83837-2111 Ph: (208) 784-5801 |
| NPI Number | 1356763122 |
|---|---|
| Provider Enumeration Date | 01/14/2014 |
| Last Update Date | 01/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356763122 | NPI | - | NPPES |
| 1396810255 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D1923 (Idaho) | Primary |
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