NPI age
17 years
Enumerated 2008-06-24
Across 591 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 805467000 | |
| 01 (ID) | 6C503 | BLUE CROSS OF IDAHO |
| 01 (ID) | 559572 | UNITED CONCORDIA |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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