NPI age
1 years
Enumerated 2025-05-20
● Active Type 2 · Organization
Subpart
Clark Oral & Facial Surgery - Burley
Clark Oral & Facial Surgery - Burley is 1 of 11 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Holmes
Practice Manager
Last NPPES update
2025-05-20
Source: monthly bulk 2026-05
How this organization compares
Across 11 active clinic/center providers in Idaho.
NPI age
1 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2025 → 2026
2025-05Enumerated in NPPES
2025
2026
Where they practice
Primary practice location
1404 Pomerelle Ave Ste A2
Burley, ID 833182013
Mailing address
1404 Pomerelle Ave Ste A2
Burley, ID 833182013
Authorized official
Durella Dee Holmes
Practice Manager
📞 2088312900
Specialties
-
Clinic/Center PrimaryThe 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.
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Clark Oral & Facial Surgery, PC
Practice context
Single-site organization. Only one practice location on file.
Subpart of Clark Oral & Facial Surgery - Burley.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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