# POPPLETON FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1972765865
- **Authorized official:** DR. KYLE DAVID POPPLETON D.D.S. (OWNER)
- **Authorized official phone:** (208) 733-0695

## Contact information

- **Practice address:** 1001 SHOSHONE ST N, TWIN FALLS, ID 83301-6364
- **Practice address phone:** (208) 733-0695
- **Practice address fax:** (208) 736-4540
- **Mailing address:** 1001 SHOSHONE ST N, TWIN FALLS, ID 83301-6364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D-3554 | ID | Yes |

## Other

- **Enumeration date:** 07/01/2008
- **Last updated:** 07/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 806115400 | — | ID |