Southridge Dental

LBN: Todd L Squires Ddc Pllc
Southridge Dental is an health care organization with primary practice located at 2811 12Th Ave Rd , Nampa ID 83686. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Dental. Dental Providers / General Practice is the primary health care specialty. Todd L Squires Ddc Pllc can be contacted via phone (208) 466-2458, or through Squires, Todd Lawrence via phone (801) 682-3097.

Contact Information

Primary practice address
2811 12Th Ave Rd Nampa ID 83686
Fax: (208) 465-6303
Website:
Authorized official contact:
Name: Squires, Todd Lawrence Doctor of Dental Surgery (DDS)

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1457593584
LBN Legal business name Todd L Squires Ddc Pllc
DBA Doing business as Southridge Dental
Authorized official Squires, Todd Lawrence Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 6th, 2009
Last updated May 27th, 2020 - about 6 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 1457593584 NPPES
Idaho MEDICAID 1063894145

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