Id Sds II Pllc
NPI #1861265647 in Pocatello, Idaho
Provider Information
- NPI Number
- 1861265647
- Entity Type
- Organization
- Organization Name
- Id Sds II Pllc
- Primary Specialty
- Dentist - Orthodontics and Dentofacial Orthopedics
- Enumeration Date
- Nov 2, 2023
- Last Updated
- Mar 5, 2025
Practice Location
Authorized Official
- Name
- CHARLOTTE E VIAL
- Title
- DIREC OF CRED AND PROV REL
- Phone
- (615) 638-0303
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
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