Crookston Dental PLLC
Clinic/Center, Dental in Meridian, ID. Organization (NPI-2).
NPI number1982508727
StatusActive
Last updated in NPPESOct 6, 2026
Details
- NPI
- 1982508727
- Entity type
- Organization (NPI-2)
- Legal business name
- Crookston Dental PLLC
- Organization subpart
- No
- Enumeration date
- Oct 6, 2026
- Certification date
- Oct 5, 2026
- Last updated
- Oct 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
2015 N Locust Grove RdMeridian, ID 83646-1827
Phone 208-377-3206
Mailing address
2015 N Locust Grove RdMeridian, ID 83646-1827
Phone 208-377-3206
Authorized official
Devon Merrill Crookston
Dentist/Owner
2088996592
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