| Canyon Falls Dental P.l.l.c. | |
|
143 E Main St Jerome ID 83338-2332 | |
| (208) 324-7007 | |
| (307) 324-7540 |
| Full Name | Canyon Falls Dental P.l.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 143 E Main St, Jerome, Idaho |
| Authorized Official Name and Position | Janice A Jones (BOOKKEEPER) |
| Authorized Official Contact | 2083247007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Falls Dental P.l.l.c. 143 E Main St Jerome ID 83338-2332 Ph: (208) 324-7007 | Canyon Falls Dental P.l.l.c. 143 E Main St Jerome ID 83338-2332 Ph: (208) 324-7007 |
| NPI Number | 1760494249 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 01/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760494249 | NPI | - | NPPES |
| 8064016 | Medicaid | ID | |
| 8067306 | Medicaid | ID | |
| 8081167 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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