Young, Dallin C

Young, Dallin C is an sole proprietor health care provider with primary practice located at 1186 Eastland Dr N Suite B, Twin Falls ID 83301-8973. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Young, Dallin C can be contacted via phone (208) 733-9331.

Contact Information

Primary practice address
1186 Eastland Dr N Suite B Twin Falls ID 83301-8973
Fax: (208) 732-1222
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X D-3874-PD Idaho

Profile Details

NPI number 1932193869
LBN Legal business name Young, Dallin C
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 7th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932193869 NPPES
Illinois Other 6N474 BLUE CROSS PROVIDER ID
Illinois Other 000010151637 BLUE CROSS PROVIDER ID
Illinois MEDICAID 807215900 BLUE CROSS PROVIDER ID

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