| NPI | 1033854740 |
|---|---|
| Doing Business As | IDAHO KIDS DENTISTRY & ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | CASSANDRA WIETH Director Of Payor Relations 623-267-8121 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2025-12-18 |