Excellence In Dentistry Pa

LBN: Excellence In Dentistry Pa
Excellence In Dentistry Pa is an health care organization with primary practice located at 2515 Channing Way , Idaho Falls ID 83404-7516. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Excellence In Dentistry Pa can be contacted via phone (208) 529-4321, or through Godfrey, Duane Kent via phone (208) 529-4321.

Contact Information

Primary practice address
2515 Channing Way Idaho Falls ID 83404-7516
Phone: (208) 529-4321
Fax: (208) 529-8609
Website:
Map and Directions
Authorized official contact:
Name: Godfrey, Duane Kent Doctor of Dental Surgery (DDS)
Phone: (208) 529-4321

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D1637 Idaho
Dental Providers / General Practice 1223G0001X D3983 Idaho

Profile Details

NPI number 1881602266
LBN Legal business name Excellence In Dentistry Pa
DBA Doing business as
Authorized official Godfrey, Duane Kent Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 3rd, 2006
Last updated Dec 17th, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881602266 NPPES
Idaho MEDICAID 807539000
Idaho MEDICAID 000755500

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