OrganizationActive
Id Specialty Dental Services, PLLC
NPI 1013757830 · Orthodontics and Dentofacial Orthopedics Dentistry · Pocatello, ID
Provider details
- NPI number
- 1013757830
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Parent organization
- Id Specialty Dental Services, PLLC
- Authorized official
- Charlotte Dasch, Director of Cred and Prov Rel
Mailing address
1610 54th Ave N Ste 205
Nashville, TN 37209-1442
Registry dates
- Enumerated
- 2024-05-29
- Last updated
- 2024-05-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.