Organization
GREEN ACRES DENTAL PLLC
Active
Other names
Green Acres Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIAL)
(972) 869-3789
Entity
Organization
Contact information
Practice address
871 GREEN ACRES DR, TWIN FALLS, ID 83301-3353
(208) 733-4620
Mailing address
871 GREEN ACRES DR, TWIN FALLS, ID 83301-3353
(208) 733-4620
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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