Avalon Dental Pc

LBN: Avalon Dental Pc
Avalon Dental Pc is an health care organization with primary practice located at 672 E Wythe Creek Ct Ste 101, Kuna ID 83634-5216. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Avalon Dental Pc can be contacted via phone (208) 629-2800, or through Grant, James D. via phone (208) 629-2800.

Contact Information

Primary practice address
672 E Wythe Creek Ct Ste 101 Kuna ID 83634-5216
Phone: (208) 629-2800
Fax: (208) 629-2801
Website:
Map and Directions
Authorized official contact:
Name: Grant, James D. Doctor of Dental Medicine (DMD)
Phone: (208) 629-2800

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X D3875 Idaho

Profile Details

NPI number 1962850933
LBN Legal business name Avalon Dental Pc
DBA Doing business as
Authorized official Grant, James D. Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2016
Last updated May 31st, 2016 - about 10 years ago

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 1962850933 NPPES
Idaho Other 1447345491 INDIVIDUAL PROVIDER

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