Oneida Family Dental LLC

NPI #1316454333 in Malad City, Idaho

Provider Information

NPI Number
1316454333
Entity Type
Organization
Organization Name
Oneida Family Dental LLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Dec 29, 2017
Last Updated
Dec 29, 2017

Practice Location

Address
150 S MAIN ST APT 16
State
Idaho
ZIP Code
83252-1405
Phone
(208) 904-3614

Authorized Official

Name
SHENELL CLARK
Title
OFFICE MANAGER
Phone
(208) 904-3614

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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