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2300 W Everest Ln Ste 125 Meridian ID 83646-6113 | |
| (208) 938-6343 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2300 W Everest Ln Ste 125, Meridian, Idaho |
| Authorized Official Name and Position | Joel E Whitt (PRESIDENT) |
| Authorized Official Contact | 2086312212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3235 N Towerbridge Way Ste 200 Meridian ID 83646-5721 Ph: (208) 888-7711 | 2300 W Everest Ln Ste 125 Meridian ID 83646-6113 Ph: (208) 938-6343 |
| NPI Number | 1205330420 |
|---|---|
| Provider Enumeration Date | 03/21/2018 |
| Last Update Date | 03/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205330420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D3868-PD (Idaho) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (Idaho) | Secondary |
The Center For Sleep Apnea And Tmj Pa Dental Clinic Medicare: Medicare Enrolled Practice Location: 1718 S. Millennium Way, Meridian, ID 83642 Phone: 208-376-3600 Fax: 208-376-3616 | |
Willow Tree Dental Group Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 W Cherry Ln, Meridian, ID 83642 Phone: 208-472-7817 Fax: 208-345-2601 |