Idaho Center for Oral and Facial Surgery
Idaho Center for Oral and Facial Surgery is an Oral and Maxillofacial Surgery Clinic/Center in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2010.
- Licensed in
- ID
- In the registry since
- 2010
Practice location Address checks out
177 Vista DrPocatello, ID 83201-5824
Phone: (208) 232-0232
Fax: (208) 232-2044
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Oral and Maxillofacial Surgery Clinic/Center (primary) | Taxonomy 261QS0112X · Licence D-4276-OS (ID) |
|---|
Record details
| NPI number | 1558675298 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jeffrey Dabell — Surgeon · (208) 232-0232 |
| NPI enumerated | August 5, 2010 |
| Last updated in NPPES | November 30, 2010 |
| Mailing address | 177 Vista Dr, Pocatello, ID 83201-5824 |