Organization
EAGLE DENTAL PARTNERSHIP PLLC
Active
Other names
Ascend Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEAH M. GARDOSKI (INSURANCE ADMINISTRATOR)
(208) 939-3500
Entity
Organization
Contact information
Practice address
577 E STATE ST, EAGLE, ID 83616-5938
(208) 939-3500
(208) 939-3837
Mailing address
577 E STATE ST, EAGLE, ID 83616-5938
(208) 939-3500
(208) 939-3837
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/18/2019
Last updated
08/11/2025
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