Organization
ADVANTAGE DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESTER ALBERT RICHINS D.M.D. (DOCTOR/OWNER)
(208) 884-0888
Entity
Organization
Contact information
Practice address
100 W OVERLAND RD, MERIDIAN, ID 83642-3051
(208) 884-0888
(208) 895-8533
Mailing address
100 W OVERLAND RD, MERIDIAN, ID 83642-3051
(208) 884-0888
(208) 895-8533
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3186
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001606900
—
ID
01
—
6F126
OTHER
ID
Enumeration date
06/02/2008
Last updated
06/02/2008
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