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Organization

IDAHO DENTAL PROFESSIONALS, P.C.

Active
Parent organization
IDAHO DENTAL PROFESSIONALS, P.C.
Other names
Highbrook Way Dental Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
IDAHO DENTAL PROFESSIONALS, P.C.
Authorized official
BELINDA HUERTA (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization

Contact information

Practice address
140 N HIGHBROOK WAY STE 102, STAR, ID 83669-1029
(208) 600-0522
(208) 600-0496
Mailing address
140 N HIGHBROOK WAY STE 102, STAR, ID 83669-1029
(208) 600-0522
(208) 600-0496

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
08/29/2023
Last updated
08/29/2023
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