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NPI Code Detail

MEDICARE: ALEXANDRA ROCHELLE HYDER DDS

MEDICARE: ALEXANDRA ROCHELLE HYDER DDS
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
1122300000XDentistD-4953ID

General Provider Information

NPI Number : 1730665241
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA ROCHELLE HYDER DDS
Provider Business Mailing Address
First Line : 7379 NEWBROOK DR
Second Line :
City : NAMPA
State : ID
Zip : 83687-8353
Country : US
Telephone Number : 610-451-5297
Fax Number :
Provider Business Practice Location Address
First Line : 6657 N GLENWOOD ST
Second Line :
City : BOISE
State : ID
Zip : 83714-1925
Country : US
Telephone Number : 208-375-0572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2018
Last Update Date : 12/10/2024

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