Eagle Oral Surgery and Dental Implant Center PLLC
Eagle Oral Surgery and Dental Implant Center PLLC is an Oral and Maxillofacial Surgery (Dentist) in Eagle, Idaho. Licensed in Idaho. Registered with an NPI since 2015.
- Licensed in
- ID
- In the registry since
- 2015
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
197 W State StEagle, ID 83616-4959
Phone: (208) 995-2865
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Oral and Maxillofacial Surgery (Dentist) (primary) | Taxonomy 1223S0112X · Licence D-4617-OS (ID) |
|---|
Record details
| NPI number | 1780074864 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jeremy Hixson — Owner/Provider · (208) 451-6584 |
| NPI enumerated | January 28, 2015 |
| Last updated in NPPES | January 28, 2015 |
| Mailing address | 197 W State St, Eagle, ID 83616-4959 |