Organization
IVORY EDGE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN D HULL DDS (OWNER)
(208) 263-1412
Entity
Organization
Contact information
Practice address
1323 HIGHWAY 2, SUITE 301, SANDPOINT, ID 83864-5210
(208) 263-1412
Mailing address
1323 HIGHWAY 2, SUITE 301, SANDPOINT, ID 83864-5210
(208) 263-1412
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D-4660
ID
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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