Organization
CASTLEBURY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WEBSTER (OFFICE MANAGER)
(208) 855-0080
Entity
Organization
Contact information
Practice address
3209 W. BAVARIA ST., EAGLE, ID 83616
(208) 855-0080
(208) 855-2582
Mailing address
3209 W. BAVARIA ST., EAGLE, ID 83616
(208) 855-0080
(208) 855-2582
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3724
ID
Other
Enumeration date
03/13/2009
Last updated
03/13/2009
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