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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