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Organization
BIRD FAMILY DENTAL, PLLC
Active
Organization
BIRD FAMILY DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYSON ANDERS BIRD DDS (OWNER)
(208) 680-5144
Entity
Organization
Contact information
Practice address
8 N DIVISION ST, PINEHURST, ID 83850
(208) 682-4540
Mailing address
PO BOX 609, PINEHURST, ID 83850-0609
(208) 682-4540
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D-4491
ID
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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