Organization
FOOTHILLS DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE BERNELL MURDOCK DDS (OWNER/PARTNER)
(208) 529-4484
Entity
Organization
Contact information
Practice address
2205 CHANNING WAY, SUITE A, IDAHO FALLS, ID 83404-8016
(208) 529-4484
(208) 523-4441
Mailing address
3955 GEORGIA LN, AMMON, ID 83406-7812
(208) 529-0868
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D1719
ID
Other
Enumeration date
10/27/2006
Last updated
08/22/2020
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