Eagle River Dentistry | |
325 E Shore Dr Suite 100 Eagle ID 83616-6583 | |
(208) 938-0280 | |
Not Available |
Full Name | Eagle River Dentistry |
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Speciality | Clinic/center - Dental |
Location | 325 E Shore Dr, Eagle, Idaho |
Authorized Official Name and Position | Brooks Joseph Uniat (OWNER) |
Authorized Official Contact | 2089380280 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Eagle River Dentistry 325 E Shore Dr Suite 100 Eagle ID 83616-6583 Ph: (208) 938-0280 | Eagle River Dentistry 325 E Shore Dr Suite 100 Eagle ID 83616-6583 Ph: (208) 938-0280 |
NPI Number | 1972762342 |
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Provider Enumeration Date | 06/02/2008 |
Last Update Date | 06/02/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972762342 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | D-3666 (Idaho) | Primary |
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