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Organization
DANCE DENTISTRY PLLC
Active
Organization
DANCE DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DANCE DDS (OWNER)
(208) 772-2202
Entity
Organization
Contact information
Practice address
1027 W PRAIRIE AVE, HAYDEN, ID 83835
(208) 772-2202
(208) 772-2213
Mailing address
1027 W PRAIRIE AVE, HAYDEN, ID 83835
(208) 772-2202
(208) 772-2213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4050-PD
ID
261QD0000X
Dental Clinic/Center
D-4050-PD
ID
Other
Enumeration date
09/01/2015
Last updated
08/14/2018
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