Scott R Gardner DDS PC

NPI #1114187598 in Nampa, Idaho

Provider Information

NPI Number: 1114187598
Entity Type: Organization
Organization Name: Scott R Gardner DDS PC
Primary Specialty: Dentist
Enumeration Date: Jun 10, 2008
Last Updated: Jun 10, 2008

Practice Location

Address: 2065 12TH AVE RD
City: Nampa
State: Idaho
ZIP Code: 83686-6311
Phone: (208) 466-3239

Authorized Official

Name: SCOTT ROBERT GARDNER, DDS
Title: DETIST
Phone: (208) 466-3239

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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