# BLACKFOOT FAMILY DENTISTRY PLLC

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

## Provider details

- **NPI number:** 1578958252
- **Authorized official:** DR. CADE G BALDWIN DDS (DOCTOR)
- **Authorized official phone:** (208) 785-6833

## Contact information

- **Practice address:** 380 W JUDICIAL ST, BLACKFOOT, ID 83221-2122
- **Practice address phone:** (208) 785-6833
- **Practice address fax:** (208) 785-5362
- **Mailing address:** 380 W JUDICIAL ST, BLACKFOOT, ID 83221-2122
- **Mailing address phone:** (208) 785-6833
- **Mailing address fax:** (208) 785-5362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D3690 | ID | Yes |

## Other

- **Enumeration date:** 03/31/2015
- **Last updated:** 03/31/2015