| The Kids' Dentist, Pllc | |
|
2300 W Everest Ln Suite 125 Meridian ID 83646-5925 | |
| (208) 938-6343 | |
| (208) 884-5048 |
| Full Name | The Kids' Dentist, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2300 W Everest Ln, Meridian, Idaho |
| Authorized Official Name and Position | Lawrence Wayne Meadors (OWNER/MEMBER) |
| Authorized Official Contact | 2089386343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Kids' Dentist, Pllc 2300 W Everest Ln Suite 125 Meridian ID 83646-5925 Ph: (208) 938-6343 | The Kids' Dentist, Pllc 2300 W Everest Ln Suite 125 Meridian ID 83646-5925 Ph: (208) 938-6343 |
| NPI Number | 1679743470 |
|---|---|
| Provider Enumeration Date | 03/07/2008 |
| Last Update Date | 03/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679743470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D3120PD (Idaho) | Primary |
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