# COMMUNITY COUNCIL OF IDAHO INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CFC Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164101754
- **Authorized official:** ARNOLD CANTU (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (208) 528-7655

## Contact information

- **Practice address:** 3387 MERLIN DR, IDAHO FALLS, ID 83404
- **Practice address phone:** (208) 281-1222
- **Practice address fax:** (208) 524-9390
- **Mailing address:** 2100 ALAN ST, IDAHO FALLS, ID 83404
- **Mailing address phone:** (208) 528-7655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 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