Organization
TWIN FALLS KIDS DENTAL LLC
Active
Other names
Childrens Dentistry of Twin Falls
Organization subpart
No
Provider details
NPI number
Authorized official
LEANN SPORIN (OFFICE MANAGER)
(208) 724-3647
Entity
Organization
Contact information
Practice address
1186 EASTLAND DR N STE B, TWIN FALLS, ID 83301-8973
(208) 733-9331
Mailing address
1411 FALLS AVE E STE 1000C, TWIN FALLS, ID 83301-3459
(208) 734-7415
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
04/11/2023
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