Provider Demographics
NPI:1841395589
Name:POST FALLS FAMILY DENTAL CENTER P A
Entity Type:Organization
Organization Name:POST FALLS FAMILY DENTAL CENTER P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:208-773-4579
Mailing Address - Street 1:313 N SPOKANE ST
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9513
Mailing Address - Country:US
Mailing Address - Phone:208-773-4579
Mailing Address - Fax:208-773-0286
Practice Address - Street 1:313 N SPOKANE ST
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9513
Practice Address - Country:US
Practice Address - Phone:208-773-4579
Practice Address - Fax:208-773-0286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty