DENTAL DEPOT NPI 1023225638

NPI Information

DENTAL DEPOT is a general practice dentist in Moscow, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DENTAL DEPOT NPI is 1023225638. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

803 S JEFFERSON ST
SUITE 2
MOSCOW, ID
ZIP 83843-096
Phone: (208) 882-2531
Fax: (208) 882-5701

The provider's authorized official is Jesse Cole .
The authorized official title is Partner and has the following contact phone number (208) 882-2531.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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