NPI age
19 years
Enumerated 2006-09-08
Across 1099 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 979635 | UNITED CONCORDIA |
| 01 (ID) | 979635 | GEHA |
| 01 (ID) | 979635 | CONNECTION DENTAL PLANS |
| 01 (ID) | 000001009869 | REGENCE BLUE SHIELD OF ID |
| 01 (ID) | 6B158 | BLUE CROSS OF IDAHO |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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