NPI age
19 years
Enumerated 2007-03-06
Across 1099 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010159680 | BLUE SHIELD OF ID |
| 05 (ID) | 807635400 | |
| 01 (PA) | 1927603 | UNITED CONCORDIA |
| 01 (ID) | 6N136 | BLUE CROSS OF ID |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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