Idaho Orthodontic-Burley

NPI #1225379654 in Burley, Idaho

Provider Information

NPI Number: 1225379654
Entity Type: Organization
Organization Name: Idaho Orthodontic-Burley
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Mar 11, 2013
Last Updated: Mar 11, 2013

Practice Location

Address: 1408 POMERELLE AVE
Address 2: SUITE E
City: Burley
State: Idaho
ZIP Code: 83318-2067
Phone: (208) 678-2738

Authorized Official

Name: DR. JEFFREY TODD MCMINN, DMD
Title: ORTHODONTIST
Phone: (208) 678-2738

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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MR. Dennis J Michaelson, DMD MS	Dentist - Orthodontics and Dentofacial Orthopedics	Burley	AI Deep Dive
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Organizations

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Dennis Michaelson D.m.d., Ms	Dentist - Orthodontics and Dentofacial Orthopedics	Burley	AI Deep Dive
Justin D Ward Dmd Msd Pllc	Dentist - Orthodontics and Dentofacial Orthopedics	Burley	AI Deep Dive

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