Chubbuck Kidz Dental PC

Organization Active NPI Pediatric Dentistry · Chubbuck, ID

NPI 1801679287 · NPPES record last updated Aug 18, 2023

Key facts

NPI
1801679287
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Dentistry 1223P0221X
Legal business name
CHUBBUCK KIDZ DENTAL PC
Practice address
371 E Chubbuck Rd
Chubbuck, ID 83202
Phone
(208) 358-8871
NPI assigned
Aug 17, 2023
Organization subpart
No

Authorized official

Name
Magdalena Evans
Title
Sr. Credentialing Specialist
Phone
(720) 272-7558

National Provider Directory

Locations

371 E Chubbuck Rd
Chubbuck, ID 83202
Phone (208) 358-8871

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223P0221X Yes

Addresses

Primary practice location

371 E Chubbuck Rd
Chubbuck, ID 83202

Mailing address

371 E Chubbuck Rd
Chubbuck, ID 83202
Phone (208) 425-7690

Other providers in Chubbuck, ID

All providers in Chubbuck, ID · Pediatric Dentistry in Idaho

Sources for this page

Verify at the official NPI Registry.