Center for Dental Excellence LLC

NPI #1376852939 in Pocatello, Idaho

Provider Information

NPI Number
1376852939
Entity Type
Organization
Organization Name
Center for Dental Excellence LLC
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Sep 30, 2010
Last Updated
Nov 18, 2010

Practice Location

Address
1525 BALDY AVE
State
Idaho
ZIP Code
83201-7117
Phone
(208) 238-0011

Authorized Official

Name
DR. JEREMY L HODGE, DMD
Title
OWNER
Phone
(208) 238-0011

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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