| Summit Dental Care Paul, Pllc | |
|
207 W Ellis Street Paul ID 83347 | |
| (208) 438-4855 | |
| (208) 438-4835 |
| Full Name | Summit Dental Care Paul, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 207 W Ellis Street, Paul, Idaho |
| Authorized Official Name and Position | Alisa Frame (OFFICE MANAGER) |
| Authorized Official Contact | 2087339999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Dental Care Paul, Pllc Po Box 549 Paul ID 83347-0549 Ph: (208) 438-4855 | Summit Dental Care Paul, Pllc 207 W Ellis Street Paul ID 83347 Ph: (208) 438-4855 |
| NPI Number | 1346789534 |
|---|---|
| Provider Enumeration Date | 02/21/2017 |
| Last Update Date | 02/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346789534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D4743 (Idaho) | Primary |