Silver Lake Dental Pllc | |
6176 N Government Way Dalton Gardens ID 83815-7331 | |
(208) 762-3027 | |
(208) 762-0531 |
Full Name | Silver Lake Dental Pllc |
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Speciality | Dentist - General Practice |
Location | 6176 N Government Way, Dalton Gardens, Idaho |
Authorized Official Name and Position | James S Hough (OWNER) |
Authorized Official Contact | 2087623027 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Silver Lake Dental Pllc 6176 N Government Way Dalton Gardens ID 83815-7331 Ph: (208) 762-3027 | Silver Lake Dental Pllc 6176 N Government Way Dalton Gardens ID 83815-7331 Ph: (208) 762-3027 |
NPI Number | 1851551345 |
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Provider Enumeration Date | 06/10/2008 |
Last Update Date | 06/10/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851551345 | NPI | - | NPPES |
1223G0001X | Other | ID | GENERAL PRACTICE DENTIST |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | D3104 (Idaho) | Primary |