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Organization

POPPLETON FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KYLE DAVID POPPLETON D.D.S. (OWNER)
(208) 733-0695
Entity
Organization

Contact information

Practice address
1001 SHOSHONE ST N, TWIN FALLS, ID 83301-6364
(208) 733-0695
(208) 736-4540
Mailing address
1001 SHOSHONE ST N, TWIN FALLS, ID 83301-6364

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3554
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806115400
ID
Enumeration date
07/01/2008
Last updated
07/01/2008
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