NPI age
19 years
Enumerated 2007-04-11
Across 135 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 963311 | UCCI |
| 01 (ID) | 6G421 | BLUE CROSS OF IDAHO |
| 01 (ID) | 6G405 | BLUE CROSS OF ID |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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