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Organization

IDAHO FALLS PEDIATRIC DENTISTRY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KAILEY ANNE HOUSLEY DDS (PEDIATRIC DENTIST, OWNER)
(208) 419-3622
Entity
Organization

Contact information

Practice address
3015 EAGLE DR, AMMON, ID 83406-1273
(208) 419-3622
(208) 419-3461
Mailing address
3387 MERLIN DR, IDAHO FALLS, ID 83404-7405
(208) 419-3622
(208) 419-3461

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
06/24/2019
Last updated
05/28/2025
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