NPI 1114187598

Scott R Gardner DDS PC

Organisation Dentist Nampa, ID

Practice location

Address: 2065 12th Ave Rd, Nampa, ID 83686-6311
Phone: (208) 466-3239

Authorised official

Name: Scott Robert Gardner
Title: Detist
Phone: (208) 466-3239

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D3527 (ID)

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Registry record

NPI: 1114187598
Entity type: Organization
NPI issued: 10 Jun 2008
Record last updated: 10 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.