CHILDREN'S DENTISTRY OF POCATELLO NPI 1588823264

NPI Information

CHILDREN'S DENTISTRY OF POCATELLO is a pediatric dentistry dentist in Pocatello, ID. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. CHILDREN'S DENTISTRY OF POCATELLO NPI is 1588823264. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

425 E ALAMEDA RD
POCATELLO, ID
ZIP 83201-609
Phone: (208) 238-1165
Fax: (208) 238-1241

The provider's authorized official is Ross N Hugues .
The authorized official title is Officer and has the following contact phone number (208) 238-1165.

The enumeration date for this NPI number is 6/6/2008 and was last updated on 8/20/2014.

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:

Other Identifiers

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