Organization
IDAHO DENTAL AID, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM BENSON KELLER DDS (OWNER)
(208) 466-9088
Entity
Organization
Contact information
Practice address
604 3RD ST S, NAMPA, ID 83651-3840
(208) 466-9088
(208) 466-2294
Mailing address
604 3RD ST S, NAMPA, ID 83651-3840
(208) 466-9088
(208) 466-2294
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3065
ID
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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