# BROOKSIDE DENTAL

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

## Provider details

- **NPI number:** 1851312839
- **Authorized official:** ROBBIE ROLAND HAMBLIN D.M.D. (MANAGER)
- **Authorized official phone:** (208) 461-2600

## Contact information

- **Practice address:** 351 W IOWA AVE, NAMPA, ID 83686-2856
- **Practice address phone:** (208) 461-2600
- **Practice address fax:** (208) 461-3166
- **Mailing address:** 351 W IOWA AVE, NAMPA, ID 83686-2856
- **Mailing address phone:** (208) 461-2600
- **Mailing address fax:** (208) 461-3166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3312 | ID | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 08/22/2020