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General NPI Number Information
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NPI Number | 1881918027
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Entity Type | Organization
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Legal Business Name | DENTAL CARE WEST, LLC
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 1015 CALDWELL BLVD
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City | NAMPA
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State | ID
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Zip | 83651-1717
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Country | US
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Telephone | 208-442-1088
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Fax | 208-442-1085
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Provider Business Mailing Address
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Address Line | 1015 CALDWELL BLVD
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City | NAMPA
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State | ID
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Zip | 83651-1717
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Country | US
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Telephone | 208-442-1088
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Fax | 208-442-1085
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. WADE PILLING
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Credential | DMD
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Telephone | 208-442-1088
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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 | D3877
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License Number State | ID
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