Two Rivers Dental, Pllc | |
125 S 10th E Mtn Home ID 83647-3120 | |
(208) 587-4326 | |
Not Available |
Full Name | Two Rivers Dental, Pllc |
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Speciality | Dentist - General Practice |
Location | 125 S 10th E, Mtn Home, Idaho |
Authorized Official Name and Position | Shane Newton (OWNER) |
Authorized Official Contact | 2085874326 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Two Rivers Dental, Pllc 125 S 10th E Mtn Home ID 83647-3120 Ph: (208) 587-4326 | Two Rivers Dental, Pllc 125 S 10th E Mtn Home ID 83647-3120 Ph: (208) 587-4326 |
NPI Number | 1114156064 |
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Provider Enumeration Date | 07/13/2009 |
Last Update Date | 07/13/2009 |
Identifier | Type | State | Issuer |
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1114156064 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | D3280 (Idaho) | Primary |
Family Dental Care Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 925 Airbase Rd, Mtn Home, ID 83647 Phone: 208-587-2222 Fax: 208-587-9100 |