Eagle Dental Partnership Pllc

NPI #1639732399 in Eagle, Idaho

Provider Information

NPI Number: 1639732399
Entity Type: Organization
Organization Name: Eagle Dental Partnership Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 18, 2019
Last Updated: Aug 11, 2025

Practice Location

Address: 577 E STATE ST
City: Eagle
State: Idaho
ZIP Code: 83616-5938
Phone: (208) 939-3500

Authorized Official

Name: MRS. LEAH M. GARDOSKI
Title: INSURANCE ADMINISTRATOR
Phone: (208) 939-3500

Specialties & Taxonomy Codes

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

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