| Idaho Falls Pediatric Dentistry, Pllc | |
|
3015 Eagle Dr Ammon ID 83406-1273 | |
| (208) 419-3622 | |
| (208) 419-3461 |
| Full Name | Idaho Falls Pediatric Dentistry, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3015 Eagle Dr, Ammon, Idaho |
| Authorized Official Name and Position | Kailey Anne Housley (PEDIATRIC DENTIST, OWNER) |
| Authorized Official Contact | 2084193622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Falls Pediatric Dentistry, Pllc 3387 Merlin Dr Idaho Falls ID 83404-7405 Ph: (208) 419-3622 | Idaho Falls Pediatric Dentistry, Pllc 3015 Eagle Dr Ammon ID 83406-1273 Ph: (208) 419-3622 |
| NPI Number | 1700447596 |
|---|---|
| Provider Enumeration Date | 06/24/2019 |
| Last Update Date | 05/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700447596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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