National Provider Identifier Database

IDAHO CENTER FOR ORAL AND FACIAL SURGERY
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

IDAHO CENTER FOR ORAL AND FACIAL SURGERY
177 VISTA DR
POCATELLO, ID83201-5824
Phone: 208-232-0232
Fax: 208-232-2044
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for IDAHO CENTER FOR ORAL AND FACIAL SURGERY

NPI Number 1558675298
Legal business name
LBN
IDAHO CENTER FOR ORAL AND FACIAL SURGERY
Authorized official JEFFREY DABELL - (SURGEON)
Entity Organization
Organization subpart No
Enumeration date 08/05/2010
Last updated 11/30/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: D-4276-OS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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