Provider Demographics
NPI:1215611827
Name:RAMSEY DENTAL GROUP PLLC
Entity type:Organization
Organization Name:RAMSEY DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-772-4500
Mailing Address - Street 1:9095 N HESS ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-9827
Mailing Address - Country:US
Mailing Address - Phone:208-772-4500
Mailing Address - Fax:208-772-4551
Practice Address - Street 1:9095 N HESS ST STE 201
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-9827
Practice Address - Country:US
Practice Address - Phone:208-772-4500
Practice Address - Fax:208-772-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty