| Moulton Periodontics, Pllc | |
|
2375 E Sunnyside Rd Suite I Idaho Falls ID 83404-8280 | |
| (208) 522-6683 | |
| (208) 552-3085 |
| Full Name | Moulton Periodontics, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2375 E Sunnyside Rd, Idaho Falls, Idaho |
| Authorized Official Name and Position | Ethan D Moulton (OWNER) |
| Authorized Official Contact | 2085226683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moulton Periodontics, Pllc 2375 E Sunnyside Rd Suite I Idaho Falls ID 83404-8280 Ph: (208) 522-6683 | Moulton Periodontics, Pllc 2375 E Sunnyside Rd Suite I Idaho Falls ID 83404-8280 Ph: (208) 522-6683 |
| NPI Number | 1104085935 |
|---|---|
| Provider Enumeration Date | 06/06/2008 |
| Last Update Date | 06/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104085935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D-4093-PE (Idaho) | Primary |
Sunnyside Dental Care Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 Elk Creek Dr, Idaho Falls, ID 83404 Phone: 208-522-8854 | |
T And H Enterprises, Dmd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3315 S Holmes Ave, Idaho Falls, ID 83404 Phone: 208-522-4491 | |
Soft Touch Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3350 S 15 Th E, Idaho Falls, ID 83404 Phone: 208-522-4700 | |
Id Dental Associates, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2818 S 25th E, Idaho Falls, ID 83404 Phone: 208-243-8391 Fax: 208-243-8391 | |
Mccord Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3411 Merlin Dr, Idaho Falls, ID 83404 Phone: 208-529-8333 | |
Mongillo Orthodontics, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 S Skyline Dr Ste 4, Idaho Falls, ID 83402 Phone: 208-524-1404 | |
Sleep Better Idaho Falls Llc Dental Clinic Medicare: Medicare Enrolled Practice Location: 2238 Saratoga Dr, Idaho Falls, ID 83404 Phone: 208-701-2720 Fax: 208-701-2939 |