# BIRCHWOOD DENTAL, PLLC

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

## Provider details

- **NPI number:** 1891304556
- **Authorized official:** DR. GAYLAN CHRIS HOLDAWAY DDS (PRESIDENT)
- **Authorized official phone:** (336) 509-0278

## Contact information

- **Practice address:** 3325 N TEN MILE RD STE 140, MERIDIAN, ID 83646-6951
- **Practice address phone:** (208) 228-5499
- **Practice address fax:** (855) 204-6128
- **Mailing address:** 3325 N TEN MILE RD STE 140, MERIDIAN, ID 83646-6951
- **Mailing address phone:** (208) 228-5499
- **Mailing address fax:** (855) 204-6128

## Taxonomy

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

## Other

- **Enumeration date:** 07/29/2020
- **Last updated:** 08/10/2020