Mudrow Family Dental | |
333 S Woodruff Ave Idaho Falls ID 83401-4322 | |
(208) 524-2036 | |
Not Available |
Full Name | Mudrow Family Dental |
---|---|
Speciality | Dentist |
Location | 333 S Woodruff Ave, Idaho Falls, Idaho |
Authorized Official Name and Position | Kevin Richard Mudrow (OWNER/GENERAL DENTIST) |
Authorized Official Contact | 2085242036 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mudrow Family Dental 333 S Woodruff Ave Idaho Falls ID 83401 Ph: (208) 524-2036 | Mudrow Family Dental 333 S Woodruff Ave Idaho Falls ID 83401-4322 Ph: (208) 524-2036 |
NPI Number | 1235565003 |
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Provider Enumeration Date | 09/24/2013 |
Last Update Date | 09/24/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235565003 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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