Healthcare Provider Details

I. General information

NPI: 1972256733
Provider Name (Legal Business Name): ZOLA DENTAL NAMPA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3161 E GREENHURST RD
NAMPA ID
83686-8655
US

IV. Provider business mailing address

3161 E GREENHURST RD
NAMPA ID
83686-8655
US

V. Phone/Fax

Practice location:
  • Phone: 208-466-9915
  • Fax: 208-466-6625
Mailing address:
  • Phone: 208-466-9915
  • Fax: 208-466-6625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY SKAAR
Title or Position: INSURANCE COORDINATOR
Credential:
Phone: 208-466-9915