Idaho City Family Dentistry
NPI #1992964597 in Idaho City, Idaho
Provider Information
- NPI Number
- 1992964597
- Entity Type
- Organization
- Organization Name
- Idaho City Family Dentistry
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 9, 2008
- Last Updated
- Jun 9, 2008
Practice Location
- Address
- 219 MAIN STREET
- City
- Idaho City
- State
- Idaho
- ZIP Code
- 83631
- Phone
- (208) 392-9900
Authorized Official
- Name
- DR. SHANE D VANIA, DDS
- Title
- DENTIST
- Phone
- (208) 392-9900
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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