Organization
MAGIC VALLEY DENTAL ANESTHESIA PLLC
Active
Organization
MAGIC VALLEY DENTAL ANESTHESIA PLLC
Active
Other names
Magic Valley Dental Anesthesia PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN JUDD DMD (OWNER)
(503) 679-9797
Entity
Organization
Contact information
Practice address
1411 FALLS AVE E STE 1000C, TWIN FALLS, ID 83301-3459
(208) 734-7415
Mailing address
3245 S BRANDENBERG AVE, EAGLE, ID 83616-4413
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Enumeration date
05/05/2021
Last updated
05/05/2021
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