Organization
IDAHO DENTAL PROFESSIONALS, P.C.
Active
Parent organization
IDAHO DENTAL PROFESSIONALS, P.C.
Other names
Quail Run Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
IDAHO DENTAL PROFESSIONALS, P.C.
Authorized official
CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
(217) 764-8609
Entity
Organization
Contact information
Practice address
2003 E QUAIL RUN RD, EMMETT, ID 83617-5059
(208) 365-3534
Mailing address
2003 E QUAIL RUN RD, EMMETT, ID 83617-5059
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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