Organization
IDAHO DENTAL AID PLLC
Active
Other names
Smiles 4 Kids
Organization subpart
No
Provider details
NPI number
Authorized official
MADISON LEHMAN (CREDENTIALING SPECIALIST)
(720) 603-4779
Entity
Organization
Contact information
Practice address
987 S. RISING SUN DRIVE, #101, NAMPA, ID 83686
(208) 466-9088
(208) 466-2294
Mailing address
987 S. RISING SUN DRIVE, #101, NAMPA, ID 83686
(208) 466-9088
(208) 466-2294
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
122300000X
ID
Other
Enumeration date
05/09/2013
Last updated
03/25/2022
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