Organization
KISTLER DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA KISTLER (OWNER)
(208) 243-8391
Entity
Organization
Contact information
Practice address
2818 S 25TH E, IDAHO FALLS, ID 83404-6509
(208) 243-8391
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
06/20/2023
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