Rigby Pediatric Dental PLLC
Dentist, Pediatric Dentistry in Rigby, ID. Organization (NPI-2).
NPI number1124657010
StatusActive
Last updated in NPPESApr 3, 2020
Details
- NPI
- 1124657010
- Entity type
- Organization (NPI-2)
- Legal business name
- Rigby Pediatric Dental PLLC
- Organization subpart
- No
- Enumeration date
- Apr 3, 2020
- Certification date
- Apr 3, 2020
- Last updated
- Apr 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | Yes |
Other names
- Rigby Pediatric Dental (Doing Business As)
Practice location
688 Rigby Lake Circle, Suite 4Rigby, ID 83442
Phone 208-600-0330
Mailing address
Po Box 191Iona, ID 83427-0191
Phone 208-716-9724
Authorized official
Kory Bingham
Managing Member
2087169724
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