Center For Oral & Facial Surgery

LBN: Idaho Oral Surgery Pllc
Center For Oral & Facial Surgery is an health care organization with primary practice located at 1820 N Whitley Dr , Fruitland ID 83619-2163. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Idaho Oral Surgery Pllc can be contacted via phone (208) 452-4808, or through Hillam, Ryan David via phone (208) 452-4808.

Contact Information

Primary practice address
1820 N Whitley Dr Fruitland ID 83619-2163
Phone: (208) 452-4808
Fax: (208) 452-6617
Website:
Map and Directions
Authorized official contact:
Name: Hillam, Ryan David Doctor of Dental Surgery (DDS)
Phone: (208) 452-4808

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X D3949OS Idaho

Profile Details

NPI number 1912172958
LBN Legal business name Idaho Oral Surgery Pllc
DBA Doing business as Center For Oral & Facial Surgery
Authorized official Hillam, Ryan David Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 29th, 2008
Last updated Apr 19th, 2010 - about 14 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 1912172958 NPPES
Oregon MEDICAID 241342
Oregon MEDICAID 807651700

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