Organization · Type 2 NPI

Russell Guymon Orthodontics, PA

Orthodontics and Dentofacial Orthopedics Dentistry · Idaho Falls, ID

NPI number 1194097402 Active

Practice location

333 S Woodruff Ave
Idaho Falls, ID 83401-4322

Call (208) 529-3500 Map

Specialties and licenses

TaxonomyCodeLicense
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400XD-4402-OR (ID)

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…

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About NPI 1194097402

Russell Guymon Orthodontics, PA's National Provider Identifier is 1194097402, issued on Feb 1, 2012. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Idaho Falls, ID. The record was last updated on Feb 1, 2012.