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Contact Information

POTLATCH FAMILY DENTAL, PC
225 6TH STREET
POTLATCH, ID83855
 Phone: 208-875-0441
 Fax: 208-875-0972
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for POTLATCH FAMILY DENTAL, PC

NPI # 1245515832
LBN Legal business name POTLATCH FAMILY DENTAL, PC
Authorized official AMMON PITT - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 10/15/2011
Last updated 10/15/2011 - About 15 years ago
Identifiers
ID License # D3984
ID Medicaid 8075010
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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