Id Specialty Dental Services, Pllc
NPI #1013757830 in Pocatello, Idaho
Provider Information
- NPI Number
- 1013757830
- Entity Type
- Organization
- Organization Name
- Id Specialty Dental Services, Pllc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- ID SPECIALTY DENTAL SERVICES, PLLC
- Primary Specialty
- Dentist - Orthodontics and Dentofacial Orthopedics
- Enumeration Date
- May 29, 2024
- Last Updated
- May 29, 2024
Practice Location
Authorized Official
- Name
- CHARLOTTE DASCH
- Title
- DIRECTOR OF CRED AND PROV REL
- Phone
- (504) 638-0303
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
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