Russell Guymon Orthodontics, Pa

LBN: Russell Guymon Orthodontics, Pa
Russell Guymon Orthodontics, Pa is an health care organization with primary practice located at 333 S Woodruff Ave , Idaho Falls ID 83401-4322. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Russell Guymon Orthodontics, Pa can be contacted via phone (208) 529-3500, or through Guymon, Russell J via phone (208) 529-3500.

Contact Information

Primary practice address
333 S Woodruff Ave Idaho Falls ID 83401-4322
Phone: (208) 529-3500
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Guymon, Russell J DDS, MS
Phone: (208) 529-3500

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X D-4402-OR Idaho

Profile Details

NPI number 1194097402
LBN Legal business name Russell Guymon Orthodontics, Pa
DBA Doing business as
Authorized official Guymon, Russell J DDS, MS
Entity Organization
Organization subpart 1 No
Enumeration date Feb 1st, 2012
Last updated Feb 1st, 2012 - about 13 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 1194097402 NPPES
Idaho MEDICAID 10584378285

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