| Idaho Falls Oral And Facial Surgery | |
|
3905 Washington Pkwy Idaho Falls ID 83404-7596 | |
| (208) 528-6000 | |
| Not Available |
| Full Name | Idaho Falls Oral And Facial Surgery |
|---|---|
| Speciality | Dentist |
| Location | 3905 Washington Pkwy, Idaho Falls, Idaho |
| Authorized Official Name and Position | Gregory Mcgee (PRESIDENT) |
| Authorized Official Contact | 2085211891 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Falls Oral And Facial Surgery 2184 Channing Way Ste 229 Idaho Falls ID 83404-8034 Ph: (505) 205-6618 | Idaho Falls Oral And Facial Surgery 3905 Washington Pkwy Idaho Falls ID 83404-7596 Ph: (208) 528-6000 |
| NPI Number | 1477023778 |
|---|---|
| Provider Enumeration Date | 11/29/2018 |
| Last Update Date | 07/24/2019 |
| Medicare PECOS PAC ID | 5294061529 |
|---|---|
| Medicare Enrollment ID | O20190724003658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477023778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Gregory R Mcgee |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1891756367 PECOS PAC ID: 8729204607 Enrollment ID: I20190725000213 |
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