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General NPI Number Information
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NPI Number | 1962568782
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Entity Type | Organization
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Legal Business Name | DENTAL PARTNERS, PLLC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 203 7TH AVE S
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City | NAMPA
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State | ID
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Zip | 83651-3846
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Country | US
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Telephone | 208-466-8400
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Fax | 208-466-8436
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Provider Business Mailing Address
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Address Line | 203 7TH AVE S
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City | NAMPA
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State | ID
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Zip | 83651-3846
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Country | US
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Telephone | 208-466-8400
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Fax | 208-466-8436
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KAT M MILTON
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Credential |
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Telephone | 208-466-8400
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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 | D3610
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License Number State | ID
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