Individual
DOUGLAS J MESSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3 E CENTER ST, SUGAR CITY, ID 83448-1247
(208) 656-2000
Mailing address
553 E 1000 N, FIRTH, ID 83236-1103
(208) 680-6750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4750
ID
1223G0001X
General Practice Dentistry
9624
MT
Other
Enumeration date
06/25/2015
Last updated
07/13/2016
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