Organization
BYRD DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN LUKE BYRD D.D.S. (OWNER)
(208) 786-7031
Entity
Organization
Contact information
Practice address
302 E CAMERON AVE, KELLOGG, ID 83837-2333
(208) 786-7031
Mailing address
302 E CAMERON AVE, KELLOGG, ID 83837-2333
(208) 786-7031
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4696
ID
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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