NPI age
19 years
Enumerated 2006-08-11
Across 591 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 001422900 | |
| 01 (ID) | 519891 | UNITED CONCORDIA ID NUMBE |
| 01 (ID) | 60852 | BLUE CROSS OF IDAHO |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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