Two Rivers Dental, Pllc | |
810 Hwy 93 S Challis ID 83226 | |
(208) 879-2124 | |
(208) 879-2169 |
Full Name | Two Rivers Dental, Pllc |
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Speciality | Dentist - General Practice |
Location | 810 Hwy 93 S, Challis, Idaho |
Authorized Official Name and Position | Shane Lee Newton (OWNER) |
Authorized Official Contact | 2083152842 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Two Rivers Dental, Pllc Po Box 298 Challis ID 83226-0298 Ph: (208) 879-2124 | Two Rivers Dental, Pllc 810 Hwy 93 S Challis ID 83226 Ph: (208) 879-2124 |
NPI Number | 1962644260 |
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Provider Enumeration Date | 04/01/2009 |
Last Update Date | 04/01/2009 |
Identifier | Type | State | Issuer |
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1962644260 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | D3280 (Idaho) | Primary |
Challis Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 S 12th St, Challis, ID 83226 Phone: 208-589-9107 |