NPI 1093974446
Willow Tree Dental Group LLC
Practice location
- Address
- 317 W Cherry Ln, Meridian, ID 83642-1608
- Phone
- (208) 472-7817
- Fax
- (208) 345-2601
Authorised official
- Name
- Shannon Love
- Title
- Financial Manager
- Phone
- (208) 472-7817
Registered specialties
Periodontics
Primary
Registry record
- NPI
- 1093974446
- Entity type
- Organization
- NPI issued
- 2 Jun 2008
- Record last updated
- 2 Jun 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.