# PEGGY J TREBILCOCK DDS PC

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

## Provider details

- **NPI number:** 1477712966
- **Authorized official:** PEGGY J TREBILCOCK DDS (DENTIST)
- **Authorized official phone:** (208) 782-0242

## Contact information

- **Practice address:** 2407 TEEPLES DR, BLACKFOOT, ID 83221-5877
- **Practice address phone:** (208) 782-0242
- **Practice address fax:** (208) 782-1160
- **Mailing address:** 2407 TEEPLES DR, BLACKFOOT, ID 83221-5877
- **Mailing address phone:** (208) 782-0242
- **Mailing address fax:** (208) 782-1160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D3133 | ID | Yes |

## Other

- **Enumeration date:** 06/09/2008
- **Last updated:** 06/09/2008