Organization · Type 2 NPI
Modern Smiles Pocatello PC
Dental Clinic/Center · Pocatello, ID
NPI number
1609592435
Active
Practice location
1800 Flandro Dr Ste 340
Pocatello, ID 83202-4944
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1609592435
Modern Smiles Pocatello PC's National Provider Identifier is 1609592435, issued on Oct 13, 2022. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Pocatello, ID. The record was last updated on Feb 10, 2023.