| Byrd Dentistry, Pllc | |
|
302 E Cameron Ave Kellogg ID 83837-2333 | |
| (208) 786-7031 | |
| Not Available |
| Full Name | Byrd Dentistry, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 302 E Cameron Ave, Kellogg, Idaho |
| Authorized Official Name and Position | Benjamin Luke Byrd (OWNER) |
| Authorized Official Contact | 2087867031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Byrd Dentistry, Pllc 302 E Cameron Ave Kellogg ID 83837-2333 Ph: (208) 786-7031 | Byrd Dentistry, Pllc 302 E Cameron Ave Kellogg ID 83837-2333 Ph: (208) 786-7031 |
| NPI Number | 1790155430 |
|---|---|
| Provider Enumeration Date | 10/06/2015 |
| Last Update Date | 10/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790155430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-4696 (Idaho) | Primary |
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