Organization · Type 2 NPI

Southeast Idaho Orthodontics, PLLC

Orthodontics and Dentofacial Orthopedics Dentistry · Pocatello, ID

NPI number 1508080599 Active

Practice location

625 E Alameda Rd
Pocatello, ID 83201-3622

Fax (208) 237-7982

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…

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About NPI 1508080599

Southeast Idaho Orthodontics, PLLC's National Provider Identifier is 1508080599, issued on Apr 12, 2007. 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 Aug 22, 2020.