| Scott R Gardner Dds Pc | |
|
2065 12th Ave Rd Nampa ID 83686-6311 | |
| (208) 466-3239 | |
| Not Available |
| Full Name | Scott R Gardner Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 2065 12th Ave Rd, Nampa, Idaho |
| Authorized Official Name and Position | Scott Robert Gardner (DETIST) |
| Authorized Official Contact | 2084663239 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott R Gardner Dds Pc 2065 12th Ave Rd Nampa ID 83686-6311 Ph: (208) 466-3239 | Scott R Gardner Dds Pc 2065 12th Ave Rd Nampa ID 83686-6311 Ph: (208) 466-3239 |
| NPI Number | 1114187598 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 06/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114187598 | NPI | - | NPPES |
| 806096200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D3527 (Idaho) | Primary |
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