Idaho Facial Imaging Llc

LBN: Idaho Facial Imaging Llc
Idaho Facial Imaging Llc is an health care organization with primary practice located at 8119 Ustick Rd Suite 101, Boise ID 83704-5754. The organization recently has only one registered license in Ambulatory Health Care Facilities / Radiology, which is considered as the primary health care specialty. Idaho Facial Imaging Llc can be contacted via phone (208) 514-4740, or through Stauts, Braden M via phone (208) 514-4740.

Contact Information

Primary practice address
8119 Ustick Rd Suite 101 Boise ID 83704-5754
Phone: (208) 514-4740
Fax: (208) 376-7012
Website:
Map and Directions
Authorized official contact:
Name: Stauts, Braden M Doctor of Dental Surgery (DDS)
Phone: (208) 514-4740

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X 4-D-2095 Idaho

Profile Details

NPI number 1437178399
LBN Legal business name Idaho Facial Imaging Llc
DBA Doing business as
Authorized official Stauts, Braden M Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 19th, 2006
Last updated Aug 22nd, 2020 - about 4 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 1437178399 NPPES
Idaho Other 000010156829 REGENCE BLUE SHIELD-MEDIC
Idaho Other 000010156827 REGENCE BLUE SHIELD-MEDIC

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