National Provider Identifier Database

WHITEWATER WOODRIVER ORAL 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

WHITEWATER WOODRIVER ORAL SURGERY
400 S MAIN ST STE 202
HAILEY, ID83333-8856
Phone: 208-788-5308
Fax:
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for WHITEWATER WOODRIVER ORAL SURGERY

NPI Number 1790202810
Legal business name
LBN
WHITEWATER WOODRIVER ORAL SURGERY
Authorized official MARIE BERRY - (MANAGER)
Entity Organization
Organization subpart No
Enumeration date 08/29/2017
Last updated 07/21/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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