| Aspen Orthodontics | |
|
197 Stockham Blvd Suite A Rigby ID 83442 | |
| (208) 745-7407 | |
| (208) 745-7365 |
| Full Name | Aspen Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 197 Stockham Blvd, Rigby, Idaho |
| Authorized Official Name and Position | Phillip David Lowder (OWNER) |
| Authorized Official Contact | 2087457407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Orthodontics P.o. 246 Rigby ID 83442 Ph: (208) 745-7407 | Aspen Orthodontics 197 Stockham Blvd Suite A Rigby ID 83442 Ph: (208) 745-7407 |
| NPI Number | 1548431588 |
|---|---|
| Provider Enumeration Date | 03/18/2008 |
| Last Update Date | 03/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548431588 | NPI | - | NPPES |
| 807770200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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