| Russell C. Pool, Dmd, Pa | |
|
109 12th Ave Rd Nampa ID 83686-5047 | |
| (208) 467-2545 | |
| (208) 466-3607 |
| Full Name | Russell C. Pool, Dmd, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 109 12th Ave Rd, Nampa, Idaho |
| Authorized Official Name and Position | Russell C. Pool (PRESIDENT) |
| Authorized Official Contact | 2084672545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell C. Pool, Dmd, Pa 109 12th Ave Rd Nampa ID 83686-5047 Ph: (208) 467-2545 | Russell C. Pool, Dmd, Pa 109 12th Ave Rd Nampa ID 83686-5047 Ph: (208) 467-2545 |
| NPI Number | 1093977647 |
|---|---|
| Provider Enumeration Date | 06/25/2008 |
| Last Update Date | 06/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093977647 | NPI | - | NPPES |
| 66852 | Other | ID | BLUE SHIELD OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D1687 (Idaho) | Primary |
Southridge Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2811 12th Ave Rd, Nampa, ID 83686 Phone: 208-466-2458 Fax: 208-465-6303 | |
Dba Ronald J. Albright Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 11th St S, Nampa, ID 83651 Phone: 208-463-1800 | |
Jmj Holding Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 914 12th Ave Rd Ste 102, Nampa, ID 83686 Phone: 208-996-3010 | |
Onsite Dental, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 524 E Fujii Dr, Nampa, ID 83686 Phone: 844-667-4834 Fax: 208-376-3616 | |
Christian C. Cusimano Dds, Ms, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 W Iowa Ave, Nampa, ID 83686 Phone: 208-467-4362 Fax: 208-463-9080 | |
Scott R Gardner Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2065 12th Ave Rd, Nampa, ID 83686 Phone: 208-466-3239 |