Individual
LAYNE K MCCORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1943 MADISON AVE, IDAHO FALLS, ID 83404-1203
(208) 529-8333
(208) 522-0851
Mailing address
1943 MADISON AVE, IDAHO FALLS, ID 83404-1203
(208) 529-8333
(208) 522-0851
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30219
IA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D4203OR
ID
Other
Enumeration date
05/17/2007
Last updated
12/29/2023
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