| Summit View Dental Services Pllc | |
|
211 E Custer St Mackay ID 83251 | |
| (208) 588-3316 | |
| (208) 588-3316 |
| Full Name | Summit View Dental Services Pllc |
|---|---|
| Speciality | Dentist |
| Location | 211 E Custer St, Mackay, Idaho |
| Authorized Official Name and Position | Brent Charles Goldthorpe (OWNER/PRESIDENT) |
| Authorized Official Contact | 4068461586 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit View Dental Services Pllc Po Box 86 Mackay ID 83251-0086 Ph: (208) 588-3316 | Summit View Dental Services Pllc 211 E Custer St Mackay ID 83251 Ph: (208) 588-3316 |
| NPI Number | 1265878995 |
|---|---|
| Provider Enumeration Date | 05/21/2013 |
| Last Update Date | 05/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265878995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-4080 (Idaho) | Primary |
| 261QD0000X | Clinic/center - Dental | D-4080 (Idaho) | Secondary |
Two Rivers Dental, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 304 S Main St, Mackay, ID 83251 Phone: 208-588-3316 Fax: 208-588-3166 | |
O-bar Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 304 So Main, Mackay, ID 83251 Phone: 208-588-3316 Fax: 208-588-3166 |