# IDAHO DENTAL PROFESSIONALS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** IDAHO DENTAL PROFESSIONALS, P.C.
- **Other names:** Quail Run Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467315275
- **Legal business name:** IDAHO DENTAL PROFESSIONALS, P.C.
- **Authorized official:** CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 764-8609

## Contact information

- **Practice address:** 2003 E QUAIL RUN RD, EMMETT, ID 83617-5059
- **Practice address phone:** (208) 365-3534
- **Mailing address:** 2003 E QUAIL RUN RD, EMMETT, ID 83617-5059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2025
- **Last updated:** 12/08/2025