Foothills Dental Care, Pllc

NPI #1205175668 in Idaho Falls, Idaho

Provider Information

NPI Number: 1205175668
Entity Type: Organization
Organization Name: Foothills Dental Care, Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: FOOTHILLS DENTAL CARE, PLLC
Primary Specialty: Dentist
Enumeration Date: Feb 5, 2013
Last Updated: Feb 6, 2013

Practice Location

Address: 1655 PANCHERI DR
City: Idaho Falls
State: Idaho
ZIP Code: 83402-3169
Phone: (208) 522-1911

Authorized Official

Name: MRS. MELISSA K RAICHART
Title: INSURANCE COORDINATOR
Phone: (208) 529-4484

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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