| Enduradent Pllc | |
|
33 East Harper Ave Driggs ID 83422 | |
| (208) 521-7888 | |
| Not Available |
| Full Name | Enduradent Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 33 East Harper Ave, Driggs, Idaho |
| Authorized Official Name and Position | Jacob A Tall (GENERAL DENTIST) |
| Authorized Official Contact | 2085217888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enduradent Pllc 1805 Eagles Homestead Dr Ammon ID 83406-4757 Ph: (208) 521-7888 | Enduradent Pllc 33 East Harper Ave Driggs ID 83422 Ph: (208) 521-7888 |
| NPI Number | 1720656598 |
|---|---|
| Provider Enumeration Date | 06/16/2021 |
| Last Update Date | 06/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720656598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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