| Townsquare Dental Of Blackfoot Pllc | |
|
1120 Parkway Dr Blackfoot ID 83221-1651 | |
| (208) 785-0878 | |
| Not Available |
| Full Name | Townsquare Dental Of Blackfoot Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1120 Parkway Dr, Blackfoot, Idaho |
| Authorized Official Name and Position | Boone Allen (OWNER) |
| Authorized Official Contact | 2087850878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Townsquare Dental Of Blackfoot Pllc 1120 Parkway Dr Blackfoot ID 83221-1651 Ph: (208) 785-0878 | Townsquare Dental Of Blackfoot Pllc 1120 Parkway Dr Blackfoot ID 83221-1651 Ph: (208) 785-0878 |
| NPI Number | 1861260093 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 12/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861260093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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