| Hathaway And Pelletier Family Dental Pllc | |
|
1217 E Iron Eagle Dr Eagle ID 83616-6599 | |
| (208) 377-1161 | |
| (208) 938-0567 |
| Full Name | Hathaway And Pelletier Family Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1217 E Iron Eagle Dr, Eagle, Idaho |
| Authorized Official Name and Position | Benjamin E Tuinei (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6027506897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hathaway And Pelletier Family Dental Pllc 1217 E Iron Eagle Dr Eagle ID 83616-6599 Ph: (208) 377-1161 | Hathaway And Pelletier Family Dental Pllc 1217 E Iron Eagle Dr Eagle ID 83616-6599 Ph: (208) 377-1161 |
| NPI Number | 1790387959 |
|---|---|
| Provider Enumeration Date | 11/12/2020 |
| Last Update Date | 11/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790387959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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Eagle Dental Partnership Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 577 E State St, Eagle, ID 83616 Phone: 208-342-4644 | |
Premier Dentistry Of Eagle Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 467 S Rivershore Ln, Eagle, ID 83616 Phone: 208-938-1247 | |
Eagle Oral Surgery And Dental Implant Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 197 W State St, Eagle, ID 83616 Phone: 208-995-2865 | |
Evan Hathaway Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1217 E Iron Eagle Dr, Eagle, ID 83616 Phone: 208-377-1161 Fax: 208-938-0567 |