FOUR SEASON DENTAL PC NPI 1215102439

NPI Information

NPI: 1215102439
Provider Name: FOUR SEASON DENTAL PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
115 E CHAPEL RD
POCATELLO, ID
ZIP 83201
Phone: (208) 237-6848
Get Directions

FOUR SEASON DENTAL PC is a general practice dentist in Pocatello, 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. FOUR SEASON DENTAL PC NPI is 1215102439. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

115 E CHAPEL RD
POCATELLO, ID
ZIP 83201
Phone: (208) 237-6848
Fax: (208) 237-6811

The provider's authorized official is Liz John .
The authorized official title is Office Manager and has the following contact phone number (208) 237-6848.

The enumeration date for this NPI number is 4/29/2008 and was last updated on 4/29/2008.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	D3808	IDAHO	No
2	1223G0001X	Dentist	General Practice	D1967	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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