# TWIN FALLS DENTAL GROUP PLLC

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

## Provider details

- **NPI number:** 1720520505
- **Authorized official:** CHRISTOPHER HANSEN DDS (DENTIST/PARTNER)
- **Authorized official phone:** (208) 733-2621

## Contact information

- **Practice address:** 788 EASTLAND DR STE A, TWIN FALLS, ID 83301-6826
- **Practice address phone:** (208) 733-2621
- **Practice address fax:** (208) 733-1086
- **Mailing address:** 3548 WASHINGTON PKWY, IDAHO FALLS, ID 83404-4968
- **Mailing address phone:** (208) 524-2300
- **Mailing address fax:** (208) 545-8447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D4164 | ID | Yes |

## Other

- **Enumeration date:** 11/10/2016
- **Last updated:** 11/10/2016