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General NPI Number Information
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NPI Number | 1124781083
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Entity Type | Organization
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Legal Business Name | NS NORTH, PLLC
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 16548 N FRANKLIN RD
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City | NAMPA
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State | ID
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Zip | 83687-8212
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Country | US
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Telephone | 208-461-3070
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Fax |
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Provider Business Mailing Address
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Address Line | 624 3RD ST S
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City | NAMPA
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State | ID
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Zip | 83651-3840
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Country | US
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Telephone | 208-586-3333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIM B. KELLER
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Credential | DDS
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Telephone | 208-461-3070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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