| The Family Dental Center, Pllc | |
|
625 W Bridge St Blackfoot ID 83221-2018 | |
| (208) 785-2685 | |
| (208) 785-0998 |
| Full Name | The Family Dental Center, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 625 W Bridge St, Blackfoot, Idaho |
| Authorized Official Name and Position | Karen J. Pruett (OFFICE MANAGER) |
| Authorized Official Contact | 2087852685 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Family Dental Center, Pllc Po Box 458 Blackfoot ID 83221-0458 Ph: (208) 785-2685 | The Family Dental Center, Pllc 625 W Bridge St Blackfoot ID 83221-2018 Ph: (208) 785-2685 |
| NPI Number | 1538186366 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538186366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3613 (Idaho) | Primary |
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