Organization
208 DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC REID GOETTSCHE DMD (MANAGER)
(208) 501-8860
Entity
Organization
Contact information
Practice address
53 E CALDERWOOD DR # 110, MERIDIAN, ID 83642-7440
(208) 501-8860
(208) 501-8862
Mailing address
53 E CALDERWOOD DR # 110, MERIDIAN, ID 83642-7440
(208) 501-8860
(208) 501-8862
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/28/2020
Last updated
07/11/2022
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