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Contact Information

MCKEE IDAHO DENTAL
1541 E CLARK ST
POCATELLO, ID83201-4100
 Phone: 208-232-6400
 Fax: 208-232-6050
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for MCKEE IDAHO DENTAL

NPI # 1972319085
LBN Legal business name MCKEE IDAHO DENTAL
Authorized official PAUL CLARK - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/04/2024
Last updated 12/09/2024 - More than a year 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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