| Two Rivers Dental, Pllc | |
|
513 E Main St Weiser ID 83672-2225 | |
| (208) 549-1732 | |
| (208) 549-4050 |
| Full Name | Two Rivers Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 513 E Main St, Weiser, Idaho |
| Authorized Official Name and Position | Shane Newton (OWNER) |
| Authorized Official Contact | 2085491732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Two Rivers Dental, Pllc 513 E Main St Weiser ID 83672-2225 Ph: (208) 549-1732 | Two Rivers Dental, Pllc 513 E Main St Weiser ID 83672-2225 Ph: (208) 549-1732 |
| NPI Number | 1417154592 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417154592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D3280 (Idaho) | Primary |
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