Idaho Dental Professionals, P.c.

NPI #1407579477 in Meridian, Idaho

Provider Information

NPI Number: 1407579477
Entity Type: Organization
Organization Name: Idaho Dental Professionals, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: IDAHO DENTAL PROFESSIONALS, P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 23, 2022
Last Updated: Sep 23, 2022

Practice Location

Address: 3177 W MILANO DR
City: Meridian
State: Idaho
ZIP Code: 83646-7290
Phone: (208) 228-7104

Authorized Official

Name: BELINDA HUERTA
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-2100

Specialties & Taxonomy Codes

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

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