Organization · Type 2 NPI
Idaho Center for Oral and Facial Surgery
Oral and Maxillofacial Surgery Clinic/Center · Pocatello, ID
NPI number
1558675298
Active
Practice location
177 Vista Dr
Pocatello, ID 83201-5824
Fax (208) 232-2044
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery Clinic/Center Primary | 261QS0112X | D-4276-OS (ID) |
Oral and Maxillofacial Surgery Clinic/Center: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
About NPI 1558675298
Idaho Center for Oral and Facial Surgery's National Provider Identifier is 1558675298, issued on Aug 5, 2010. The primary taxonomy on file is Oral and Maxillofacial Surgery Clinic/Center (261QS0112X), and the practice location is in Pocatello, ID. The record was last updated on Nov 30, 2010.