# IDAHO DENTAL AID PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Smiles 4 Kids
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912342544
- **Authorized official:** MADISON LEHMAN (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (720) 603-4779

## Contact information

- **Practice address:** 987 S. RISING SUN DRIVE, \#101, NAMPA, ID 83686
- **Practice address phone:** (208) 466-9088
- **Practice address fax:** (208) 466-2294
- **Mailing address:** 987 S. RISING SUN DRIVE, \#101, NAMPA, ID 83686
- **Mailing address phone:** (208) 466-9088
- **Mailing address fax:** (208) 466-2294

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 122300000X | ID | Yes |

## Other

- **Enumeration date:** 05/09/2013
- **Last updated:** 03/25/2022