Id Dental Associates, P.c.

NPI #1033560578 in Idaho Falls, Idaho

Provider Information

NPI Number: 1033560578
Entity Type: Organization
Organization Name: Id Dental Associates, P.c.
Primary Specialty: Dentist
Enumeration Date: Jun 27, 2016
Last Updated: Jun 27, 2016

Practice Location

Address: 2818 S 25TH E
City: Idaho Falls
State: Idaho
ZIP Code: 83404
Phone: (208) 243-8391

Authorized Official

Name: JASON BERTOLLINI
Title: PRS
Phone: (866) 273-8204

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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