# CASTLEBURY DENTAL PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1881835353
- **Authorized official:** JENNIFER WEBSTER (OFFICE MANAGER)
- **Authorized official phone:** (208) 855-0080

## Contact information

- **Practice address:** 3209 W. BAVARIA ST., EAGLE, ID 83616
- **Practice address phone:** (208) 855-0080
- **Practice address fax:** (208) 855-2582
- **Mailing address:** 3209 W. BAVARIA ST., EAGLE, ID 83616
- **Mailing address phone:** (208) 855-0080
- **Mailing address fax:** (208) 855-2582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D3724 | ID | Yes |

## Other

- **Enumeration date:** 03/13/2009
- **Last updated:** 03/13/2009