| Mountain View Dentistry | |
|
615 W North St Grangeville ID 83530-1239 | |
| (208) 983-0105 | |
| (208) 983-2339 |
| Full Name | Mountain View Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 615 W North St, Grangeville, Idaho |
| Authorized Official Name and Position | Ashlee Behler (SECRETARY) |
| Authorized Official Contact | 2089830105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain View Dentistry 615 W North St Grangeville ID 83530-1239 Ph: (208) 983-0105 | Mountain View Dentistry 615 W North St Grangeville ID 83530-1239 Ph: (208) 983-0105 |
| NPI Number | 1295994408 |
|---|---|
| Provider Enumeration Date | 06/03/2008 |
| Last Update Date | 06/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295994408 | NPI | - | NPPES |
| 807500900 | Medicaid | ID | |
| 807665400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3987 (Idaho) | Primary |
| 1223G0001X | Dentist - General Practice | D3978 (Idaho) | Secondary |
Two Rivers Family & Cosmetic Dentistry, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 N A St, Grangeville, ID 83530 Phone: 200-898-3165 |