NPI age
19 years
Enumerated 2006-08-01
Across 64 active dentist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 534917 | UNITED CONCORDIA |
| 01 (ID) | 6D626 | BLUE CROSS OF IDAHODENTAL |
| 01 (ID) | 6M048 | BLUE CROSS OF IDAHO MED |
| 01 (ID) | BLUE SHIELD | 45250 |
| 05 (ID) | 002577900 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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