NPI age
19 years
Enumerated 2006-12-28
Across 1099 active dentist providers in Idaho.
5 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010143908 | BLUE SHIELD OF ID |
| 05 (ID) | 806628200 | |
| 01 (PA) | 01478887 | UNITED CONCORDIA |
| 01 (ID) | 6H361 | BLUE CROSS |
Multi-provider organization. 5 individual providers on file at this primary address.
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