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Organization
ALLIED DENTAL CLINIC, PC
Active
Organization
ALLIED DENTAL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL C SNOW DMD (OWNER)
(208) 237-0563
Entity
Organization
Contact information
Practice address
1246 YELLOWSTONE AVE STE B3, POCATELLO, ID 83201-4372
(208) 237-0563
Mailing address
1246 YELLOWSTONE AVE STE B3, POCATELLO, ID 83201-4372
(208) 237-0563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3171
ID
Other
Enumeration date
05/10/2007
Last updated
08/22/2020
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