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
- City
- Malad City
- 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 Practice — General Practice |
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