| Dance Dentistry Pllc | |
|
1027 W Prairie Ave Hayden ID 83835 | |
| (208) 772-2202 | |
| (208) 772-2213 |
| Full Name | Dance Dentistry Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1027 W Prairie Ave, Hayden, Idaho |
| Authorized Official Name and Position | Thomas Dance (OWNER) |
| Authorized Official Contact | 2087722202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dance Dentistry Pllc 1027 W Prairie Ave Hayden ID 83835 Ph: (208) 772-2202 | Dance Dentistry Pllc 1027 W Prairie Ave Hayden ID 83835 Ph: (208) 772-2202 |
| NPI Number | 1548637994 |
|---|---|
| Provider Enumeration Date | 09/01/2015 |
| Last Update Date | 08/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548637994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D-4050-PD (Idaho) | Primary |
| 261QD0000X | Clinic/center - Dental | D-4050-PD (Idaho) | Secondary |
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