Organization
BROOKSIDE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBBIE ROLAND HAMBLIN D.M.D. (MANAGER)
(208) 461-2600
Entity
Organization
Contact information
Practice address
351 W IOWA AVE, NAMPA, ID 83686-2856
(208) 461-2600
(208) 461-3166
Mailing address
351 W IOWA AVE, NAMPA, ID 83686-2856
(208) 461-2600
(208) 461-3166
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3312
ID
Other
Enumeration date
07/22/2006
Last updated
08/22/2020
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