Denture Clinic of Pocatello, Inc.

NPI #1720419674 in Pocatello, Idaho

Provider Information

NPI Number: 1720419674
Entity Type: Organization
Organization Name: Denture Clinic of Pocatello, Inc.
Subpart: Yes (part of a larger organization)
Parent Organization: DENTURE CLINIC OF POCATELLO, INC.
Primary Specialty: Denturist
Enumeration Date: Dec 3, 2013
Last Updated: Dec 3, 2013

Practice Location

Address: 115 S 15TH AVE STE D
City: Pocatello
State: Idaho
ZIP Code: 83201-4052
Phone: (208) 232-2558

Authorized Official

Name: MR. GENO ALAN GIOVANINI, L.D
Title: OWNER
Phone: (208) 232-2558

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Denturist	122400000X	Primary

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