Alligator Pediatric Dentistry ,Pllc

LBN: Alligator Pediatric Dentistry ,Pllc
Alligator Pediatric Dentistry ,Pllc is an health care organization with primary practice located at 2805 Eagle Drive , Ammon ID 83406. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Alligator Pediatric Dentistry ,Pllc can be contacted via phone (208) 542-1333, or through Smith, Randy G. via phone (208) 542-1333.

Contact Information

Primary practice address
2805 Eagle Drive Ammon ID 83406
Phone: (208) 542-1333
Fax: (208) 552-7296
Website:
Map and Directions
Authorized official contact:
Name: Smith, Randy G. Doctor of Dental Surgery (DDS)
Phone: (208) 542-1333

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X D3257PD Idaho

Profile Details

NPI number 1679747588
LBN Legal business name Alligator Pediatric Dentistry ,Pllc
DBA Doing business as
Authorized official Smith, Randy G. Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 22nd, 2008
Last updated Apr 8th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679747588 NPPES
Idaho MEDICAID 8041268000

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