| Club 32 Dental Caldwell Pllc | |
|
1916 Ellis Ave Caldwell ID 83605-4811 | |
| (208) 466-2456 | |
| Not Available |
| Full Name | Club 32 Dental Caldwell Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1916 Ellis Ave, Caldwell, Idaho |
| Authorized Official Name and Position | Kim Keller (OWNER) |
| Authorized Official Contact | 2085063233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Club 32 Dental Caldwell Pllc 624 3rd St S Nampa ID 83651-3840 Ph: (208) 506-3233 | Club 32 Dental Caldwell Pllc 1916 Ellis Ave Caldwell ID 83605-4811 Ph: (208) 466-2456 |
| NPI Number | 1033796305 |
|---|---|
| Provider Enumeration Date | 03/24/2021 |
| Last Update Date | 03/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033796305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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