NPI age
19 years
Enumerated 2007-05-10
Across 1099 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 69625 | BLUE CROSS OF IDAHO |
| 05 (ID) | 002607400 | |
| 01 | 971248 | UNITED CONCORDIA |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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