Organization
THOMAS R. HULL D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R. HULL D.D.S. (DENTIST)
(208) 852-0194
Entity
Organization
Contact information
Practice address
35 S STATE ST, PRESTON, ID 83263-1239
(208) 852-0194
(208) 852-3817
Mailing address
35 S STATE ST, PRESTON, ID 83263-1239
(208) 852-0194
(208) 852-3817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-1973
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000837000
—
ID
01
—
6357-8
BLUE CROSS OF IDAHO
—
01
—
816458
UNITED CONCORDIA
—
Enumeration date
12/02/2009
Last updated
12/02/2009
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