| Silver Lake Dental Pllc | |
|
6176 N Government Way Dalton Gardens ID 83815-7331 | |
| (208) 762-3027 | |
| (208) 762-0531 |
| Full Name | Silver Lake Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6176 N Government Way, Dalton Gardens, Idaho |
| Authorized Official Name and Position | James S Hough (OWNER) |
| Authorized Official Contact | 2087623027 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Silver Lake Dental Pllc 6176 N Government Way Dalton Gardens ID 83815-7331 Ph: (208) 762-3027 | Silver Lake Dental Pllc 6176 N Government Way Dalton Gardens ID 83815-7331 Ph: (208) 762-3027 |
| NPI Number | 1851551345 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 06/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851551345 | NPI | - | NPPES |
| 1223G0001X | Other | ID | GENERAL PRACTICE DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3104 (Idaho) | Primary |