NPI 1063783868

Teton Valley Dental Center PLLC

Organisation Dental Clinic/Center Driggs, ID

Practice location

Address: 235 E. Wallace Ave., Driggs, ID 83442
Phone: (208) 354-8181
Fax: (208) 354-8182
Mailing address: PO Box 791 235 E., Wallace Ave., Driggs, ID 83422-0791

Authorised official

Name: James C Allen
Title: President
Phone: (208) 354-8181

Registered specialties (2)

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence D3634 (ID)

Other Clinic/Center providers in Idaho →

Dental Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence D1657 (ID)

Registry record

NPI: 1063783868
Entity type: Organization
NPI issued: 25 Jan 2012
Record last updated: 25 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.