Canyon County Oral Maxillofacial Surgery
LBN: Canyon County Oral Maxillofacial Surgery, Inc
Canyon County Oral Maxillofacial Surgery is an health care organization with primary practice located at 4121 Clock Tower Ave , Caldwell ID 83607-5006. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as the primary health care specialty.
Canyon County Oral Maxillofacial Surgery, Inc can be contacted via phone (208) 459-7800, or through Massoth, Nicholas A via phone (208) 459-7800.
Contact Information
Primary practice address
4121 Clock Tower Ave
Caldwell ID 83607-5006
Phone: (208) 459-7800
Fax:
Website:
Authorized official contact:
Name: Massoth, Nicholas A Doctor of Dental Medicine (DMD)
Phone: (208) 459-7800
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Pathology | 1223P0106X | D3848OS | Idaho |
Profile Details
| NPI number | 1710184783 |
|---|---|
| LBN Legal business name | Canyon County Oral Maxillofacial Surgery, Inc |
| DBA Doing business as | Canyon County Oral Maxillofacial Surgery |
| Authorized official | Massoth, Nicholas A Doctor of Dental Medicine (DMD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 2nd, 2007 |
| Last updated | Jul 10th, 2007 - about 18 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710184783 | NPPES |
| Idaho | Other | 10149985 | REGENCE BLUE SHIELD |
| Idaho | Other | 1783151 | REGENCE BLUE SHIELD |
| Idaho | Other | 6L859 | REGENCE BLUE SHIELD |
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