ORAL SURGERY CENTER OF IDAHO, PLLC; NPI #1841634581

Contact Information

ORAL SURGERY CENTER OF IDAHO, PLLC

1550 N CRESTMONT DR STE G
MERIDIAN, ID 83642-2177

Phone: 208-884-0100
Fax: 208-884-4844
Website:

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

Indicates primary specialty

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NPI Profile & details for ORAL SURGERY CENTER OF IDAHO, PLLC

NPI # 1841634581

LBN Legal business name ORAL SURGERY CENTER OF IDAHO, PLLC

Authorized official MICHAEL DABELL - (ORAL SURGEON)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/24/2013

Last updated 04/24/2013 - About 13 years ago

Identifiers

ID	License #	D-4099-OS
	Other	1861645202	MY PERSONAL NPI NUMBER

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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