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Organization
CSC DENTAL PC
Active
Organization
CSC DENTAL PC
Active
Other names
Happy Campers Pediatric Dental, Meridian Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLTON CHARLES DMD (OWNER)
(541) 908-1333
Entity
Organization
Contact information
Practice address
1550 E HERITAGE PARK ST STE 150, MERIDIAN, ID 83646-6440
(208) 288-2719
Mailing address
1550 E HERITAGE PARK ST STE 150, MERIDIAN, ID 83646-6440
(208) 288-2719
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33495
—
ID
Enumeration date
09/26/2021
Last updated
09/26/2021
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