Organization · Type 2 NPI
Teton Valley Dental Center PLLC
Dental Clinic/Center · Driggs, ID
NPI number
1801112628
Active
Practice location
235 E. Wallace Ave.
Driggs, ID 83422-0791
Fax (208) 354-8182
Mailing address
PO Box 791, 235 E Wallace Ave.
Driggs, ID 83422-0791
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | D-1657 (ID) |
| Dental Clinic/Center | 261QD0000X | D3634 (ID) |
Dental Clinic/Center: Definition to come...
Other dental clinic/center providers in Driggs
About NPI 1801112628
Teton Valley Dental Center PLLC's National Provider Identifier is 1801112628, issued on Apr 19, 2010. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Driggs, ID. The record was last updated on Apr 19, 2010.