| Mountain River Dental Pllc | |
|
7726 Lupine Ln Victor ID 83455-5116 | |
| (208) 787-8100 | |
| Not Available |
| Full Name | Mountain River Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 7726 Lupine Ln, Victor, Idaho |
| Authorized Official Name and Position | Curtis W Carpenter (PRESIDENT) |
| Authorized Official Contact | 2082018649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain River Dental Pllc 7726 Lupine Ln Victor ID 83455-5116 Ph: (208) 787-8100 | Mountain River Dental Pllc 7726 Lupine Ln Victor ID 83455-5116 Ph: (208) 787-8100 |
| NPI Number | 1093147696 |
|---|---|
| Provider Enumeration Date | 08/06/2013 |
| Last Update Date | 08/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093147696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-4169 (Idaho) | Primary |
Grand Teton Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 741 South 50 West, Suite A, Victor, ID 83455 Phone: 208-787-2323 Fax: 208-787-2464 | |
Mountain River Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Lupine Dr., Victor, ID 83455 Phone: 208-787-8100 Fax: 208-787-8101 | |
Mountain River Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Lupine Drive, Victor, ID 83455 Phone: 208-787-8100 Fax: 208-787-8101 | |
Grand Teton Denteal Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 741 S 50 W, Suite A, Victor, ID 83455 Phone: 208-787-2323 |