Organization
PATRICK L WAITE DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK L WAITE DDS (DENTIST)
(208) 455-0022
Entity
Organization
Contact information
Practice address
4105 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 455-0022
(208) 455-8535
Mailing address
4105 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 455-0022
(208) 455-8535
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3975
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9202298
—
ID
Enumeration date
01/03/2017
Last updated
01/03/2017
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