| Smiles 4 Kids Burley | |
|
1408 Pomerelle Ave Suite D Burley ID 83318-2064 | |
| (208) 734-7415 | |
| (208) 733-1922 |
| Full Name | Smiles 4 Kids Burley |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1408 Pomerelle Ave, Burley, Idaho |
| Authorized Official Name and Position | Trent Graff Pryor (DENTIST) |
| Authorized Official Contact | 2087347415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles 4 Kids Burley 1411 Falls Ave E Suite 1000c Twin Falls ID 83301-3455 Ph: (208) 734-7415 | Smiles 4 Kids Burley 1408 Pomerelle Ave Suite D Burley ID 83318-2064 Ph: (208) 734-7415 |
| NPI Number | 1346510237 |
|---|---|
| Provider Enumeration Date | 01/09/2012 |
| Last Update Date | 11/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346510237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 1223P0221X (Idaho) | Primary |
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