Southern Springs Dental Pllc
LBN: Southern Springs Dental Pllc
Southern Springs Dental Pllc is an health care organization with primary practice located at 1910 S Meridian Rd Ste 150, Meridian ID 83642-9061. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty.
Southern Springs Dental Pllc can be contacted via phone (208) 888-3540, or through Jardine, Barry W via phone (208) 888-3540.
Contact Information
Primary practice address
1910 S Meridian Rd Ste 150
Meridian ID 83642-9061
Phone: (208) 888-3540
Fax:
Website:
Authorized official contact:
Name: Jardine, Barry W Doctor of Dental Medicine (DMD)
Phone: (208) 888-3540
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D3807 | Idaho |
Profile Details
| NPI number | 1730348236 |
|---|---|
| LBN Legal business name | Southern Springs Dental Pllc |
| DBA Doing business as | |
| Authorized official | Jardine, Barry W Doctor of Dental Medicine (DMD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 9th, 2008 |
| Last updated | Jun 9th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730348236 | NPPES |
| Idaho | MEDICAID | 807969400 |
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