WHITEWATER WOODRIVER ORAL SURGERY; NPI #1790202810

Contact Information

WHITEWATER WOODRIVER ORAL SURGERY

400 S MAIN ST STE 202
HAILEY, ID 83333-8856

Phone: 208-788-5308
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for WHITEWATER WOODRIVER ORAL SURGERY

NPI Number	`1790202810`
LBN Legal business name	WHITEWATER WOODRIVER ORAL SURGERY
Authorized official	MARIE BERRY - (MANAGER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	08/29/2017
Last updated	07/21/2022 - About 4 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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