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Organization

COMMUNITY COUNCIL OF IDAHO INC

Active
Other names
CFC Dental
Organization subpart
No

Provider details

NPI number
Authorized official
ARNOLD CANTU (CLINIC ADMINISTRATOR)
(208) 528-7655
Entity
Organization

Contact information

Practice address
3387 MERLIN DR, IDAHO FALLS, ID 83404
(208) 281-1222
(208) 524-9390
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404
(208) 528-7655

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1223D0001X
Public Health Dentistry
1223G0001X
General Practice Dentistry
1223X0008X
Oral and Maxillofacial Radiology Dentistry

Other

Enumeration date
07/12/2023
Last updated
07/16/2025
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