| Two Rivers Family & Cosmetic Dentistry, Pa | |
|
120 N A St Grangeville ID 83530-1211 | |
| (200) 898-3165 | |
| Not Available |
| Full Name | Two Rivers Family & Cosmetic Dentistry, Pa |
|---|---|
| Speciality | Dentist |
| Location | 120 N A St, Grangeville, Idaho |
| Authorized Official Name and Position | Shane Lee Newton (OWNER) |
| Authorized Official Contact | 2086345255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Two Rivers Family & Cosmetic Dentistry, Pa 120 N A St Grangeville ID 83530-1211 Ph: (208) 983-1651 | Two Rivers Family & Cosmetic Dentistry, Pa 120 N A St Grangeville ID 83530-1211 Ph: (200) 898-3165 |
| NPI Number | 1306362587 |
|---|---|
| Provider Enumeration Date | 08/18/2017 |
| Last Update Date | 08/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306362587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D3280 (Idaho) | Primary |
Mountain View Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 W North St, Grangeville, ID 83530 Phone: 208-983-0105 Fax: 208-983-2339 |