NPI 1336036474

Teton Oms

Organisation Oral & Maxillofacial Surgery (D.M.D.) Idaho Falls, ID

Practice location

Address: 780 Bridgeport Dr, Idaho Falls, ID 83402-3370
Phone: (208) 932-4600
Fax: (208) 932-4601

Authorised official

Name: Makell Clay
Title: Practice Manager
Phone: (208) 932-4600

Registered specialties (2)

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X

Other Oral & Maxillofacial Surgery providers in Idaho →

Oral and Maxillofacial Surgery Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QS0112X

Other Clinic/Center providers in Idaho →

Registry record

NPI: 1336036474
Entity type: Organization
NPI issued: 20 Jun 2025
Record last updated: 15 May 2026

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.