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OWYHEE ORAL SURGERY LLC NPI 1114304250


NPI Information

NPI: 1114304250
Provider Name: OWYHEE ORAL SURGERY LLC
Classification: Clinic/Center - 261QS0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
1613 12TH AVE RD STE A
NAMPA, ID
ZIP 83686
Phone: (208) 505-1946
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OWYHEE ORAL SURGERY LLC is an oral and maxillofacial surgery clinic center in Nampa, ID. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. OWYHEE ORAL SURGERY LLC NPI is 1114304250. The provider is registered as an organization entity type.

The provider's business location address is:

1613 12TH AVE RD STE A
NAMPA, ID
ZIP 83686-183
Phone: (208) 505-1946

The provider's authorized official is John P Malan .
The authorized official title is Dr and has the following contact phone number (208) 505-1946.

The enumeration date for this NPI number is 4/28/2015 and was last updated on 4/28/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QS0112XClinic/CenterOral and Maxillofacial SurgeryD4557OSIDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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