Organization
CSC DENTAL PC
Active
Other names
Happy Campers Pediatric Dental, Meridian Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLTON CHARLES DMD (OWNER)
(541) 908-1333
Entity
Organization
Contact information
Practice address
1550 E HERITAGE PARK ST STE 150, MERIDIAN, ID 83646-6440
(208) 288-2719
Mailing address
1550 E HERITAGE PARK ST STE 150, MERIDIAN, ID 83646-6440
(208) 288-2719
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33495
—
ID
Enumeration date
09/26/2021
Last updated
09/26/2021
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