Southridge Dental

LBN: Southridge Dental
Southridge Dental is an health care organization with primary practice located at 2811 12Th Ave Rd , Nampa ID 83686-8482. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Southridge Dental can be contacted via phone (208) 466-2458, or through Pratt, Robert Alan via phone (208) 466-2458.

Contact Information

Primary practice address
2811 12Th Ave Rd Nampa ID 83686-8482
Phone: (208) 466-2458
Fax: (208) 465-6303
Website:
Map and Directions
Authorized official contact:
Name: Pratt, Robert Alan Doctor of Dental Medicine (DMD)
Phone: (208) 466-2458

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D-3499 Idaho

Profile Details

NPI number 1891954343
LBN Legal business name Southridge Dental
DBA Doing business as
Authorized official Pratt, Robert Alan Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 9th, 2008
Last updated Jun 18th, 2008 - about 17 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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