Individual
MICHELLE METCALF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
921 S 8TH AVE, CAMPUS BOX 8088, POCATELLO, ID 83209-8088
(208) 282-6000
Mailing address
921 S 8TH AVE, CAMPUS BOX 8088, POCATELLO, ID 83209-8088
(208) 282-6000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4692
ID
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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