| E.t. Dental Llc | |
|
418 W Cameron Ave Kellogg ID 83837-2111 | |
| (208) 682-4540 | |
| Not Available |
| Full Name | E.t. Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 418 W Cameron Ave, Kellogg, Idaho |
| Authorized Official Name and Position | Aaron Dollahite (CEO) |
| Authorized Official Contact | 2086990022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| E.t. Dental Llc 418 W Cameron Ave Kellogg ID 83837-2111 Ph: (208) 682-4540 | E.t. Dental Llc 418 W Cameron Ave Kellogg ID 83837-2111 Ph: (208) 682-4540 |
| NPI Number | 1154935039 |
|---|---|
| Provider Enumeration Date | 09/08/2020 |
| Last Update Date | 09/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154935039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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