# RAINBOW DENTAL CLINIC LLC

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

## Provider details

- **NPI number:** 1356763122
- **Authorized official:** DR. STEVEN JOSEPH RINALDI DDS (GENERAL DENTIST/ OWNER)
- **Authorized official phone:** (208) 784-5801

## Contact information

- **Practice address:** 418 W CAMERON AVE, KELLOGG, ID 83837-2111
- **Practice address phone:** (208) 784-5801
- **Practice address fax:** (208) 783-6011
- **Mailing address:** 418 W CAMERON AVE, KELLOGG, ID 83837-2111
- **Mailing address phone:** (208) 784-5801
- **Mailing address fax:** (208) 783-6011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D1923 | ID | Yes |

## Other

- **Enumeration date:** 01/14/2014
- **Last updated:** 01/14/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1396810255 | INDIVIDUAL NPI | — |