Organization
PUBLIC DENTURE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA LYNN WESTERBERG LD-32 (OWNER)
(208) 323-7790
Entity
Organization
Contact information
Practice address
2124 BLAINE ST, CALDWELL, ID 83605-4426
(208) 454-0311
Mailing address
2124 BLAINE ST, CALDWELL, ID 83605-4426
(208) 454-0311
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
LD-92
ID
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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