Organization
LITTLE SMILES PEDIATRIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY BARLOW DDS (PRESIDENT)
(208) 777-9331
Entity
Organization
Contact information
Practice address
602 N CALGARY CT, SUITE 201, POST FALLS, ID 83854-4000
(208) 777-9331
Mailing address
602 N CALGARY CT, SUITE 201, POST FALLS, ID 83854-4000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D3781-PD
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28639
—
ID
Enumeration date
04/18/2017
Last updated
04/18/2017
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