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Canyon County Oral Maxillofacial Surgery, Inc — NPI 1710184783, Caldwell, ID | NPI Central

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NPI 1710184783

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Canyon County Oral Maxillofacial Surgery, Inc

NPI 1710184783 · Oral and Maxillofacial Pathology Dentistry · Caldwell, ID

Provider details

NPI number: 1710184783
Entity type: Organization
Primary specialty: Oral and Maxillofacial Pathology DentistryDental Providers
Organization subpart: No
Authorized official: Nicholas Massoth, Oral Surgeon(208) 459-7800
License: D3848OS (ID)

Specialties & taxonomies

Oral and Maxillofacial Pathology DentistryPrimary1223P0106XLicense D3848OS (ID)
Dental Providers

Practice location

4121 Clock Tower Ave

Caldwell, ID 83607-5006

Phone: (208) 459-7800

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

4121 Clock Tower Ave

Caldwell, ID 83607-5006

Other names (DBA / former)

Doing business as: Canyon County Oral Maxillofacial Surgery

Registry dates

Enumerated: 2007-07-02
Last updated: 2007-07-10

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.