Identistry Pllc

NPI #1477144038 in Homedale, Idaho

Provider Information

NPI Number
1477144038
Entity Type
Organization
Organization Name
Identistry Pllc
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jan 27, 2021
Last Updated
Jan 27, 2021

Practice Location

Address
115 S MAIN ST
State
Idaho
ZIP Code
83628-3415
Phone
(208) 869-2243

Authorized Official

Name
DR. JARED M MARTIN, DMD
Title
CEO
Phone
(208) 869-2243

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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