| Foothills Dental Care, Pllc | |
|
1655 Pancheri Dr Idaho Falls ID 83402-3169 | |
| (208) 522-1911 | |
| (208) 523-4441 |
| Full Name | Foothills Dental Care, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1655 Pancheri Dr, Idaho Falls, Idaho |
| Authorized Official Name and Position | Melissa K Raichart (INSURANCE COORDINATOR) |
| Authorized Official Contact | 2085294484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothills Dental Care, Pllc 2205 Channing Way Suite A Idaho Falls ID 83404-8016 Ph: (208) 529-4484 | Foothills Dental Care, Pllc 1655 Pancheri Dr Idaho Falls ID 83402-3169 Ph: (208) 522-1911 |
| NPI Number | 1205175668 |
|---|---|
| Provider Enumeration Date | 02/05/2013 |
| Last Update Date | 02/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205175668 | NPI | - | NPPES |
| 1124035498 | Medicaid | ID | |
| 1740501410 | Medicaid | ID | |
| 1134356140 | Medicaid | ID | |
| 1952317703 | Medicaid | ID | |
| 1275619090 | Medicaid | ID | |
| 1609952415 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D3464 (Idaho) | Secondary |
| 122300000X | Dentist | D4302 (Idaho) | Secondary |
| 122300000X | Dentist | D1719 (Idaho) | Secondary |
| 122300000X | Dentist | D3971 (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 |