Magic Valley Oral Surgery
Dentist, Oral and Maxillofacial Surgery in Twin Falls, ID. Organization (NPI-2).
NPI number1073720009
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1073720009
- Entity type
- Organization (NPI-2)
- Legal business name
- Magic Valley Oral Surgery
- Organization subpart
- No
- Enumeration date
- May 17, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | D1658 | ID | Yes |
Practice location
590 Falls AveTwin Falls, ID 83301-3314
Phone 208-734-3562 · Fax 208-736-8339
Mailing address
590 Falls AveTwin Falls, ID 83301-3314
Phone 208-734-3562 · Fax 208-736-8339
Authorized official
Vincent Lynn Williams
Ownerpresident
2087343562
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Other Oral and Maxillofacial Surgery (Dentist) providers in Twin Falls, ID
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- Dr Mark A Plant, DDS PANPI 1700046257
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All 9 Oral and Maxillofacial Surgery (Dentist) providers in Twin Falls · All 2,311 providers in Twin Falls
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