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MAGIC VALLEY FAMILY DENTAL NPI 1477723955


NPI Information

NPI: 1477723955
Provider Name: MAGIC VALLEY FAMILY DENTAL
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
115 W 100 S
RUPERT, ID
ZIP 83350
Phone: (208) 436-4532
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MAGIC VALLEY FAMILY DENTAL is a general practice dentist in Rupert, 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. MAGIC VALLEY FAMILY DENTAL NPI is 1477723955. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

115 W 100 S
RUPERT, ID
ZIP 83350-125
Phone: (208) 436-4532

The provider's authorized official is Denise J Mallory .
The authorized official title is Office Manager and has the following contact phone number (208) 436-4532.

The enumeration date for this NPI number is 3/11/2008 and was last updated on 3/11/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeD3903IDAHOYes

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

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