Organization
SAWTOOTH DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY D DELUNA (OFFICE MANAGER)
(208) 733-4515
Entity
Organization
Contact information
Practice address
1437 PARKVIEW DR, TWIN FALLS, ID 83301-3250
(208) 733-4515
(208) 733-2757
Mailing address
1437 PARKVIEW DR, TWIN FALLS, ID 83301-3250
(208) 733-4515
(208) 733-2757
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D4141
ID
1223G0001X
General Practice Dentistry
Primary
D3263
ID
1223G0001X
General Practice Dentistry
D4137
ID
1223G0001X
General Practice Dentistry
D4582
ID
Other
Enumeration date
08/24/2006
Last updated
05/21/2015
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