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NPI Code Detail

MEDICARE: BRACES 'R' US

MEDICARE: BRACES 'R' US
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryD-3602ID

General Provider Information

NPI Number : 1083884621
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRACES 'R' US
Provider Business Mailing Address
First Line : 1431 FILLMORE ST STE 100
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-3380
Country : US
Telephone Number : 208-737-0006
Fax Number : 208-733-2630
Provider Business Practice Location Address
First Line : 1431 FILLMORE ST STE 100
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-3380
Country : US
Telephone Number : 208-737-0006
Fax Number : 208-733-2630
Authorized Official
Title or Position : OWNER/DR.
Name : DR. TROY WILLIAMS
Credential :
Telephone Number : 208-737-0006
Provider Enumeration Date : 03/11/2008
Last Update Date : 03/11/2008

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Directions to “BRACES 'R' US ” Practice Location

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