IDAHO CENTER FOR ORAL AND FACIAL SURGERY NPI 1558675298

NPI Information

IDAHO CENTER FOR ORAL AND FACIAL SURGERY is an oral and maxillofacial surgery clinic center in Pocatello, ID. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. IDAHO CENTER FOR ORAL AND FACIAL SURGERY NPI is 1558675298. The provider is registered as an organization entity type.

The provider's business location address is:

177 VISTA DR
POCATELLO, ID
ZIP 83201-824
Phone: (208) 232-0232
Fax: (208) 232-2044

The provider's authorized official is Jeffrey C Dabell .
The authorized official title is Surgeon and has the following contact phone number (208) 232-0232.

The enumeration date for this NPI number is 8/5/2010 and was last updated on 11/30/2010.

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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