Birchwood Dental, PLLC

Organization Active NPI General Practice Dentistry · Meridian, ID

NPI 1891304556 · NPPES record last updated Aug 10, 2020

Key facts

NPI
1891304556
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
BIRCHWOOD DENTAL, PLLC
Practice address
3325 N Ten Mile Rd Ste 140
Meridian, ID 83646-6951
Phone
(208) 228-5499
Fax
(855) 204-6128
NPI assigned
Jul 29, 2020
Organization subpart
No

Authorized official

Name
Dr. Gaylan Chris Holdaway, DDS NPI 1528293255
Title
President
Phone
(336) 509-0278

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

3325 N Ten Mile Rd
Ste 140
Meridian, ID 83646
Phone (208) 228-5499

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

3325 N Ten Mile Rd Ste 140
Meridian, ID 83646-6951

Mailing address

3325 N Ten Mile Rd Ste 140
Meridian, ID 83646-6951
Phone (208) 228-5499

Other providers in Meridian, ID

All providers in Meridian, ID · General Practice Dentistry in Idaho

Sources for this page

Verify at the official NPI Registry.