| Willow Tree Dental Group Llc | |
|
317 W Cherry Ln Meridian ID 83642-1608 | |
| (208) 472-7817 | |
| (208) 345-2601 |
| Full Name | Willow Tree Dental Group Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 317 W Cherry Ln, Meridian, Idaho |
| Authorized Official Name and Position | Shannon Love (FINANCIAL MANAGER) |
| Authorized Official Contact | 2084727817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Tree Dental Group Llc 317 W Cherry Ln Meridian ID 83642-1608 Ph: (208) 472-7817 | Willow Tree Dental Group Llc 317 W Cherry Ln Meridian ID 83642-1608 Ph: (208) 472-7817 |
| NPI Number | 1093974446 |
|---|---|
| Provider Enumeration Date | 06/02/2008 |
| Last Update Date | 06/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093974446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | D3443 (Idaho) | Primary |
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 | |