Organization
AVONDALE DENTAL CENTER, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A ROBSON DMD (OWNER)
(208) 772-4066
Entity
Organization
Contact information
Practice address
1683 E. MILES AVE., HAYDEN LAKE, ID 83835-9109
(208) 772-4066
Mailing address
1683 E MILES AVE, HAYDEN LAKE, ID 83835-9109
(208) 772-4066
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1572
ID
Other
Enumeration date
05/28/2009
Last updated
05/28/2009
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