Organization · Type 2 NPI

Idaho Dental Professionals, P.c.

General Practice Dentistry · Meridian, ID

NPI number 1982442448 Active

Practice location

4701 S Eagle Rd. Ste. 100
Meridian, ID 83642-7563

Fax (208) 900-3425

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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NPI record

NPI: 1982442448
Entity type: Organization (Type 2)
Issued: Jul 18, 2024
Last updated: Jul 18, 2024
Status: Active
Subpart: Yes of Idaho Dental Professionals, P.c.

Other names

South Corner Dental Care · doing business as

Authorized official

Cemyira McDougal
Credentialing Coordinator
(217) 764-8609

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1982442448

Idaho Dental Professionals, P.c.'s National Provider Identifier is 1982442448, issued on Jul 18, 2024. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Meridian, ID. The record was last updated on Jul 18, 2024.