Fairview Dental Pllc

NPI #1992480404 in Caldwell, Idaho

Provider Information

NPI Number: 1992480404
Entity Type: Organization
Organization Name: Fairview Dental Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 21, 2023
Last Updated: Jun 21, 2023

Practice Location

Address: 329 E LOGAN ST
City: Caldwell
State: Idaho
ZIP Code: 83605-4863
Phone: (208) 459-3388

Authorized Official

Name: SEAN WASDEN
Title: COO
Phone: (208) 965-9415

Specialties & Taxonomy Codes

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

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