Organization · Type 2 NPI

Ikdo Fruitland LLC

Pediatric Dentistry · Fruitland, ID

NPI number 1184108706 Active

Practice location

1619 N Whitley Dr
Fruitland, ID 83619-2162

Call (208) 452-4444 Map

Fax (208) 452-3322

Mailing address

3289 N Towerbridge Way
Meridian, ID 83646-8347

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	None listed
Orthodontics and Dentofacial Orthopedics Dentistry	1223X0400X	None listed

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Other pediatric dentistry providers in Fruitland

Childrens Dentistry of FruitlandPediatric Dentistry Fruitland, ID NPI 1619634250

See all in Fruitland →

NPI record

NPI: 1184108706
Entity type: Organization (Type 2)
Issued: Sep 19, 2018
Last updated: Apr 16, 2019
Status: Active

Other names

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Idaho Kids Dentistry & Orthodontics Fruitland · doing business as
Idaho Kids Dentistry & Orthodontics Fruitland · doing business as

Authorized official

Dr. Michael D Payne, DMD
President
(208) 371-4445

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1184108706

Ikdo Fruitland LLC's National Provider Identifier is 1184108706, issued on Sep 19, 2018. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Fruitland, ID. The record was last updated on Apr 16, 2019.