| Mountain Home Dental Pc | |
|
455 N 3rd E Mountain Home ID 83647 | |
| (208) 587-2625 | |
| Not Available |
| Full Name | Mountain Home Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 455 N 3rd E, Mountain Home, Idaho |
| Authorized Official Name and Position | Jared Sexauer (DENTIST) |
| Authorized Official Contact | 2085993189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Home Dental Pc 685 N 4th E Mountain Home ID 83647-2134 Ph: (208) 599-3189 | Mountain Home Dental Pc 455 N 3rd E Mountain Home ID 83647 Ph: (208) 587-2625 |
| NPI Number | 1801437447 |
|---|---|
| Provider Enumeration Date | 10/04/2019 |
| Last Update Date | 01/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801437447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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