Organization · Type 2 NPI

Id Specialty Dental Services, PLLC

Orthodontics and Dentofacial Orthopedics Dentistry · Pocatello, ID

NPI number 1013757830 Active

Practice location

625 E Alameda Rd
Pocatello, ID 83201-3622

Call (208) 237-0005 Map

Mailing address

1610 54th Ave N Ste 205
Nashville, TN 37209-1442

Specialties and licenses

Taxonomy	Code	License
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	None listed

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

8 other providers at this address

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NPI record

NPI: 1013757830
Entity type: Organization (Type 2)
Issued: May 29, 2024
Last updated: May 29, 2024
Status: Active
Subpart: Yes of Id Specialty Dental Services, PLLC

Other names

Idaho Orthodontics · doing business as

Authorized official

Charlotte Dasch
Director of Cred and Prov Rel
(504) 638-0303

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About NPI 1013757830

Id Specialty Dental Services, PLLC's National Provider Identifier is 1013757830, issued on May 29, 2024. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Pocatello, ID. The record was last updated on May 29, 2024.