Owyhee Oral Surgery Llc

NPI 1114304250 - Clinic/Center - 261QS0112X

NPI Details
NPI 1114304250
Enumeration Date 04/28/2015
Last Updated 04/28/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name JOHN P JOHN
Position DR
Phone (208) 505-1946
Fax
Practice Location
1613 12TH AVE RD STE A
NAMPA ID, 83686-6183, US
Phone (208) 505-1946
Fax
Business Location
1613 12TH AVE RD STE A
NAMPA ID, 83686-6183, US
Phone
Fax
Toxanomy
Taxonomy Code 261QS0112X
License State Idaho
License Number D4557OS
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According to our database, Owyhee Oral Surgery Llc NPI is 1114304250, taxonomy code is 261QS0112X and license number is D4557OS, license state is located at Idaho. Owyhee Oral Surgery Llc physically located at 1613 12th Ave Rd Ste A, Nampa ID, 83686-6183. NPI Number 1033115704 has the healthcare provider type.

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1114304250 NPI number is provided on an as is basis without warranty of any kind. 1114304250 is maintained by the National Plan & Provider Enumeration System. The contents of Owyhee Oral Surgery Llc are for informational purposes only.