| Sawtooth Periodontics Pllc | |
|
400 S Main St Ste 202 Hailey ID 83333-8856 | |
| (208) 971-4989 | |
| Not Available |
| Full Name | Sawtooth Periodontics Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 400 S Main St Ste 202, Hailey, Idaho |
| Authorized Official Name and Position | Kip Katseanes (OWNER/DOCTOR) |
| Authorized Official Contact | 8435304854 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sawtooth Periodontics Pllc 4681 S Martinel Way Meridian ID 83642-7341 Ph: (843) 530-4854 | Sawtooth Periodontics Pllc 400 S Main St Ste 202 Hailey ID 83333-8856 Ph: (208) 971-4989 |
| NPI Number | 1184482317 |
|---|---|
| Provider Enumeration Date | 03/12/2024 |
| Last Update Date | 03/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184482317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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