| Oak Mountain Dental Pllc | |
|
135 Warren Ave Pocatello ID 83201-4621 | |
| (208) 237-6453 | |
| (208) 233-4227 |
| Full Name | Oak Mountain Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 135 Warren Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Jake R Richards (DENTIST) |
| Authorized Official Contact | 2082376453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Mountain Dental Pllc 135 Warren Ave Pocatello ID 83201-4621 Ph: (208) 237-6453 | Oak Mountain Dental Pllc 135 Warren Ave Pocatello ID 83201-4621 Ph: (208) 237-6453 |
| NPI Number | 1861837478 |
|---|---|
| Provider Enumeration Date | 05/09/2013 |
| Last Update Date | 09/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861837478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-4484 (Idaho) | Primary |
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