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Organization
COMMUNITY COUNCIL OF IDAHO INC
Active
Organization
COMMUNITY COUNCIL OF IDAHO INC
Active
Other names
CFC Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ARNOLD CANTU (CLINIC ADMINISTRATOR)
(208) 528-7655
Entity
Organization
Contact information
Practice address
3387 MERLIN DR, IDAHO FALLS, ID 83404
(208) 281-1222
(208) 524-9390
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404
(208) 528-7655
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223D0001X
Public Health Dentistry
—
—
1223G0001X
General Practice Dentistry
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
Other
Enumeration date
07/12/2023
Last updated
07/16/2025
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