Idaho Oral Surgery PLLC
Idaho Oral Surgery PLLC is an Exclusive Provider Organization in Fruitland, Idaho. Licensed in Idaho. Registered with an NPI since 2008.
- Licensed in
- ID
- In the registry since
- 2008
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1820 N Whitley DrFruitland, ID 83619-2163
Phone: (208) 452-4808
Fax: (208) 452-6617
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Exclusive Provider Organization (primary) | Taxonomy 302F00000X · Licence D3949OS (ID) |
|---|
Record details
| NPI number | 1912172958 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ryan Hillam — Surgeon · (208) 452-4808 |
| Other names | Center For Oral & Facial Surgery |
| NPI enumerated | April 29, 2008 |
| Last updated in NPPES | April 19, 2010 |
| Mailing address | 1820 N Whitley Dr, Fruitland, ID 83619-2163 |