# EXCELLENCE IN DENTISTRY PA

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

## Provider details

- **NPI number:** 1881602266
- **Authorized official:** DR. DUANE KENT GODFREY DDS (DENTIST)
- **Authorized official phone:** (208) 529-4321

## Contact information

- **Practice address:** 2515 CHANNING WAY, IDAHO FALLS, ID 83404-7516
- **Practice address phone:** (208) 529-4321
- **Practice address fax:** (208) 529-8609
- **Mailing address:** 2515 CHANNING WAY, IDAHO FALLS, ID 83404-7516
- **Mailing address phone:** (208) 529-4321
- **Mailing address fax:** (208) 529-8609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D1637 | ID | Yes |
| 1223G0001X | General Practice Dentistry | D3983 | ID | — |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 12/17/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000755500 | — | ID |
| 05 | — | 807539000 | — | ID |