| Mountain River Dental | |
|
404 Lupine Drive Victor ID 83455-0487 | |
| (208) 787-8100 | |
| (208) 787-8101 |
| Full Name | Mountain River Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 404 Lupine Drive, Victor, Idaho |
| Authorized Official Name and Position | Richard H George (OWNER) |
| Authorized Official Contact | 2087878100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain River Dental 404 Lupine Drive P.o. Box 487 Victor ID 83455-0487 Ph: (208) 787-8100 | Mountain River Dental 404 Lupine Drive Victor ID 83455-0487 Ph: (208) 787-8100 |
| NPI Number | 1912136433 |
|---|---|
| Provider Enumeration Date | 07/06/2009 |
| Last Update Date | 07/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912136433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Mountain River Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7726 Lupine Ln, Victor, ID 83455 Phone: 208-787-8100 | |
Grand Teton Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 741 South 50 West, Suite A, Victor, ID 83455 Phone: 208-787-2323 Fax: 208-787-2464 | |
Mountain River Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Lupine Dr., Victor, ID 83455 Phone: 208-787-8100 Fax: 208-787-8101 | |
Grand Teton Denteal Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 741 S 50 W, Suite A, Victor, ID 83455 Phone: 208-787-2323 |