Provider Demographics
NPI:1194343152
Name:CASEBIER, KAYLA R (DDS)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:R
Last Name:CASEBIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:R
Other - Last Name:HOPKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83653-0009
Mailing Address - Country:US
Mailing Address - Phone:208-461-7149
Mailing Address - Fax:208-466-5359
Practice Address - Street 1:2301 N 36TH ST STE 102
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-5202
Practice Address - Country:US
Practice Address - Phone:208-336-8801
Practice Address - Fax:208-466-5359
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-51721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice