| Idaho City Family Dentistry | |
|
219 Main Street Idaho City ID 83631 | |
| (208) 392-9900 | |
| (208) 392-9933 |
| Full Name | Idaho City Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 219 Main Street, Idaho City, Idaho |
| Authorized Official Name and Position | Shane D Vania (DENTIST) |
| Authorized Official Contact | 2083929900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho City Family Dentistry 219 Main Street Po Box 1010 Idaho City ID 83631-1010 Ph: (208) 392-9900 | Idaho City Family Dentistry 219 Main Street Idaho City ID 83631 Ph: (208) 392-9900 |
| NPI Number | 1992964597 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 06/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992964597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |