Organization
SUMMIT DENTAL CARE PAUL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISA FRAME FAADOM (OFFICE MANAGER)
(208) 733-9999
Entity
Organization
Contact information
Practice address
207 W ELLIS STREET, PAUL, ID 83347
(208) 438-4855
(208) 438-4835
Mailing address
PO BOX 549, PAUL, ID 83347-0549
(208) 438-4855
(208) 438-4835
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4743
ID
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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