| Dansie Dental | |
|
302 N 3823 E Rigby ID 83442-5723 | |
| (208) 745-1911 | |
| (208) 745-8566 |
| Full Name | Dansie Dental |
|---|---|
| Speciality | Dentist |
| Location | 302 N 3823 E, Rigby, Idaho |
| Authorized Official Name and Position | Kristi L Radford (OFFICE MANAGER) |
| Authorized Official Contact | 2087451911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dansie Dental 302 North 3823 East Rigby ID 83442 Ph: (208) 745-1911 | Dansie Dental 302 N 3823 E Rigby ID 83442-5723 Ph: (208) 745-1911 |
| NPI Number | 1881049278 |
|---|---|
| Provider Enumeration Date | 05/04/2016 |
| Last Update Date | 05/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881049278 | NPI | - | NPPES |
| 807791400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D4055 (Idaho) | Primary |
| 1223G0001X | Dentist - General Practice | D4717 (Idaho) | Secondary |
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