Idaho Dental Professionals, P.c.

NPI #1427833409 in Star, Idaho

Provider Information

NPI Number: 1427833409
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: Aug 29, 2023
Last Updated: Aug 29, 2023

Practice Location

Address: 140 N HIGHBROOK WAY STE 102
City: Star
State: Idaho
ZIP Code: 83669-1029
Phone: (208) 600-0522

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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