NPI age
19 years
Enumerated 2006-06-28
Across 1099 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | 000010135366 | REGENCE BLUE SHIELD |
| 01 | 1444442 | UNITED CONCORDIA |
| 01 (ID) | 3400 | DELTA DENTAL |
| 01 (ID) | 6F688 | BLUE CROSS |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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