Organization
INFINITY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS TRENT SHEPHERD D.M.D. (PRESIDENT)
(505) 787-0072
Entity
Organization
Contact information
Practice address
622 CENTER ST W, KIMBERLY, ID 83341-1720
(208) 423-5001
(208) 423-4867
Mailing address
610 GARNET DR, KIMBERLY, ID 83341-1942
(605) 797-0082
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4720
ID
Other
Enumeration date
12/16/2015
Last updated
12/16/2015
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