| Shelley Dental, Inc | |
|
530 S State St Shelley ID 83274 | |
| (208) 357-2400 | |
| (208) 357-2414 |
| Full Name | Shelley Dental, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 530 S State St, Shelley, Idaho |
| Authorized Official Name and Position | John R Stohl (OWNER) |
| Authorized Official Contact | 2083572400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelley Dental, Inc 530 S State St Shelley ID 83274 Ph: (208) 357-2400 | Shelley Dental, Inc 530 S State St Shelley ID 83274 Ph: (208) 357-2400 |
| NPI Number | 1174775902 |
|---|---|
| Provider Enumeration Date | 10/10/2008 |
| Last Update Date | 10/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174775902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
River Valley Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 371 W Fir St, Shelley, ID 83274 Phone: 208-357-7611 Fax: 208-357-1805 | |
River Valley Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 371 W Fir St, Shelley, ID 83274 Phone: 208-357-7611 Fax: 208-357-1805 |