Organization
IDAHO CENTER FOR ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY C DABELL DMD, MD (SURGEON)
(208) 232-0232
Entity
Organization
Contact information
Practice address
177 VISTA DR, POCATELLO, ID 83201-5824
(208) 232-0232
(208) 232-2044
Mailing address
177 VISTA DR, POCATELLO, ID 83201-5824
(208) 232-0232
(208) 232-2044
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
D-4276-OS
ID
Other
Enumeration date
08/05/2010
Last updated
11/30/2010
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