Sunnyside Dental Care PC
NPI #1003144114 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1003144114
- Entity Type
- Organization
- Organization Name
- Sunnyside Dental Care PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 1, 2009
- Last Updated
- May 20, 2015
Practice Location
- Address
- 1520 ELK CREEK DR
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-8322
- Phone
- (208) 522-8854
Authorized Official
- Name
- EVAN O JOHNSON, D.M.D.
- Title
- PRESIDENT
- Phone
- (208) 522-8854
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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