Organization
VALLEY ORTHODONTICS
Active
Organization
VALLEY ORTHODONTICS
Active
Other names
Aspen Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP DAVID LOWDER D.D.S. M.CL.D. (OWNER)
(208) 745-7407
Entity
Organization
Contact information
Practice address
197 STOCKHAM BLVD, SUITE A, RIGBY, ID 83442
(208) 745-7407
(208) 745-7365
Mailing address
P.O. 246, RIGBY, ID 83442
(208) 745-7407
(208) 745-7365
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807770200
—
ID
Enumeration date
03/18/2008
Last updated
03/18/2008
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