| Eagle River Dentistry | |
|
325 E Shore Dr Suite 100 Eagle ID 83616-6583 | |
| (208) 938-0280 | |
| Not Available |
| Full Name | Eagle River Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 325 E Shore Dr, Eagle, Idaho |
| Authorized Official Name and Position | Brooks Joseph Uniat (OWNER) |
| Authorized Official Contact | 2089380280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle River Dentistry 325 E Shore Dr Suite 100 Eagle ID 83616-6583 Ph: (208) 938-0280 | Eagle River Dentistry 325 E Shore Dr Suite 100 Eagle ID 83616-6583 Ph: (208) 938-0280 |
| NPI Number | 1972762342 |
|---|---|
| Provider Enumeration Date | 06/02/2008 |
| Last Update Date | 06/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972762342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D-3666 (Idaho) | Primary |
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