Signature Dental PC

NPI #1356500318 in Meridian, Idaho

Provider Information

NPI Number: 1356500318
Entity Type: Organization
Organization Name: Signature Dental PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 5, 2008
Last Updated: Jun 5, 2008

Practice Location

Address: 1500 W CAYUSE CREEK DRIVE
Address 2: SUITE 100
City: Meridian
State: Idaho
ZIP Code: 83646
Phone: (208) 884-8858

Authorized Official

Name: MR. MATTHEW L KOOYMAN, DDS
Title: OWNER
Phone: (208) 884-8858

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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