208 Dental

NPI #1356945539 in Meridian, Idaho

Provider Information

NPI Number: 1356945539
Entity Type: Organization
Organization Name: 208 Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 28, 2020
Last Updated: Jul 11, 2022

Practice Location

Address: 53 E CALDERWOOD DR # 110
City: Meridian
State: Idaho
ZIP Code: 83642-7440
Phone: (208) 501-8860

Authorized Official

Name: DR. ERIC REID GOETTSCHE, DMD
Title: MANAGER
Phone: (208) 501-8860

Specialties & Taxonomy Codes

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

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