Southridge Dental in Nampa - General Practice
Southridge Dental - NPI 1003010877
Southridge Dental is a General Practice in Nampa, Idaho. Southridge Dental practices all healthcare services and medical treatments related to General Practice. The NPI Number for Southridge Dental is 1003010877. The last update date is 2020-08-22.
Southridge Dental's current location address is 2811 12th Ave Rd, Nampa, Idaho. You can contact this provider via phone number 2084662458 and fax number 2084656303. The mailing address for Southridge Dental is 2811 12th Ave Rd, Nampa, Idaho. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Southridge Dental |
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Address | 2811 12th Ave Rd, Nampa, Idaho |
Phone Number | 2084662458 |
Fax Number | 2084656303 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | DENTIST |
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Authorized Official Name | Pratt Alan Robert |
Credentials | D.M.D. |
Telephone Number | 2084662458 |
NPI Number Detail
NPI Number | 1003010877 |
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Provider Enumeration Date | 2007-06-13 |
Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
Address | 2811 12th Ave Rd |
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City | Nampa |
State | Idaho (ID) |
Post Code | 836868482 |
Phone Number | 2084662458 |
Fax Number | 2084656303 |
Provider's Primary Taxonomy Detail
Speciality | General Practice |
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Taxonomy | 1223G0001X |
Licence No | D3499 |
Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the Southridge Dental's unique identification number?
The Southridge Dental has been assigned the NPI (National Provider Identifier) Number 1003010877 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Southridge Dental?
The Southridge Dental is situated at 2811 12Th Ave Rd, in the city of Nampa, state of ID, with the zip code 836868482.
What is Southridge Dental's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Southridge Dental is General Practice, and the taxonomy code that categorizes this field of expertise is 1223G0001X.
On what date did the Southridge Dental receive its 1003010877 assignment from the Centers for Medicare & Medicaid Services?
The Southridge Dental was assigned its 1003010877 by the Centers for Medicare & Medicaid Services on 2007-06-13.
As of what date was the information pertaining to Southridge Dental, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Southridge Dental, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.
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