# ADVANCED FAMILY DENTISTRY PC

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

## Provider details

- **NPI number:** 1790796134
- **Authorized official:** DR. MARCO VINICIO GALVEZ DDS (PRESIDENT)
- **Authorized official phone:** (208) 468-0590

## Contact information

- **Practice address:** 1603-D 12TH AVE RD, NAMPA, ID 83686
- **Practice address phone:** (208) 468-0590
- **Practice address fax:** (208) 468-9910
- **Mailing address:** 1603-D 12TH AVE RD, NAMPA, ID 83686
- **Mailing address phone:** (208) 468-0590
- **Mailing address fax:** (208) 468-9910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D3047 | ID | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 08/22/2020