Madison Park Dental Center Pllc

NPI #1093849226 in Rexburg, Idaho

Provider Information

NPI Number: 1093849226
Entity Type: Organization
Organization Name: Madison Park Dental Center Pllc
Primary Specialty: Dentist
Enumeration Date: Mar 16, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 35 MADISON PROFESSIONAL PARK
City: Rexburg
State: Idaho
ZIP Code: 83440
Phone: (208) 356-5601

Authorized Official

Name: DR. ROBERT L WALKER
Title: PRESIDENT
Phone: (208) 356-5601

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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