| Rexburg Orthodontics | |
|
36 Professional Plz Suite 200 Rexburg ID 83440-2049 | |
| (208) 356-3621 | |
| (208) 356-5743 |
| Full Name | Rexburg Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 36 Professional Plz, Rexburg, Idaho |
| Authorized Official Name and Position | Andrew Summers (OWNER) |
| Authorized Official Contact | 2083563621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rexburg Orthodontics 36 Professional Plz Suite 200 Rexburg ID 83440-2049 Ph: (208) 356-3621 | Rexburg Orthodontics 36 Professional Plz Suite 200 Rexburg ID 83440-2049 Ph: (208) 356-3621 |
| NPI Number | 1215108766 |
|---|---|
| Provider Enumeration Date | 03/12/2008 |
| Last Update Date | 03/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215108766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D3625-OR (Idaho) | Primary |
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