| Oneida Family Dental Llc | |
|
150 S Main St Apt 16 Malad City ID 83252-1405 | |
| (208) 904-3614 | |
| Not Available |
| Full Name | Oneida Family Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 150 S Main St Apt 16, Malad City, Idaho |
| Authorized Official Name and Position | Shenell Clark (OFFICE MANAGER) |
| Authorized Official Contact | 2089043614 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oneida Family Dental Llc 150 S Main St Apt 16 Malad City ID 83252-1405 Ph: () - | Oneida Family Dental Llc 150 S Main St Apt 16 Malad City ID 83252-1405 Ph: (208) 904-3614 |
| NPI Number | 1316454333 |
|---|---|
| Provider Enumeration Date | 12/29/2017 |
| Last Update Date | 12/29/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316454333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D4484 (Idaho) | Primary |
Malad Valley Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 185 S 300 E, Malad City, ID 83252 Phone: 208-766-2204 Fax: 208-766-2204 |