Organization
BRETT D NAYLOR DDS PA
Active
Other names
Advanced Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT D NAYLOR D.D.S. (PRESIDENT)
(208) 852-0770
Entity
Organization
Contact information
Practice address
25 N 1ST E, PRESTON, ID 83263-1325
(208) 852-0770
(208) 852-3294
Mailing address
25 N 1ST E, PRESTON, ID 83263-1325
(208) 852-0770
(208) 852-3294
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
D3124
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002748900
—
ID
01
—
61895
BLUE CROSS NUMBER
ID
01
—
803810
UNITED CONCORDIA NUMBER
ID
Enumeration date
08/31/2006
Last updated
08/11/2008
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