Blackrock Dental Partners, Pllc

NPI #1356643308 in Pocatello, Idaho

Provider Information

NPI Number: 1356643308
Entity Type: Organization
Organization Name: Blackrock Dental Partners, Pllc
Primary Specialty: Dentist
Enumeration Date: Nov 24, 2010
Last Updated: Nov 27, 2019

Practice Location

Address: 1606 E. CENTER ST.
City: Pocatello
State: Idaho
ZIP Code: 83201-4007
Phone: (208) 232-5294

Authorized Official

Name: JOSHUA R. GIBBONS, DDS
Title: OWNER
Phone: (208) 232-5294

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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