Organization
HILLAM ORTHODONTICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN RODNEY HILLAM D.D.S., M.S.D. (ORTHODONTIST)
(208) 524-1800
Entity
Organization
Contact information
Practice address
3325 S. HOLMES AVE., IDAHO FALLS, ID 83404
(208) 524-1800
Mailing address
3325 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 524-1800
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4648
ID
Other
Enumeration date
04/20/2017
Last updated
04/20/2017
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