# WOOD RIVER DENTAL CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083877674
- **Authorized official:** DR. DANIEL T NORRIS DDS (DENTIST)
- **Authorized official phone:** (208) 788-4900

## Contact information

- **Practice address:** 317 S RIVER ST, HAILEY, ID 83333-8426
- **Practice address phone:** (208) 788-4900
- **Practice address fax:** (208) 788-1122
- **Mailing address:** PO BOX 1006, HAILEY, ID 83333-1006
- **Mailing address phone:** (208) 788-4900
- **Mailing address fax:** (208) 788-1122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D3816 | ID | Yes |

## Other

- **Enumeration date:** 07/03/2008
- **Last updated:** 07/03/2008