NPI 1073776050

Cottonwood Dental Care, PA

Organisation Dental Clinic/Center Driggs, ID

Practice location

Address: 180 S Main St Suite B2, Driggs, ID 83422-5034
Phone: (208) 354-9700
Fax: (208) 354-9701

Authorised official

Name: Stuart Marshall
Title: Dentist
Phone: (208) 354-9700

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence D3890 (ID)

Other Clinic/Center providers in Idaho →

Registry record

NPI: 1073776050
Entity type: Organization
NPI issued: 9 Jul 2008
Record last updated: 9 Jul 2008

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.