Teton Valley Dental Center Pllc

NPI #1063783868 in Driggs, Idaho

Provider Information

NPI Number
1063783868
Entity Type
Organization
Organization Name
Teton Valley Dental Center Pllc
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jan 25, 2012
Last Updated
Jan 25, 2012

Practice Location

Address
235 E. WALLACE AVE.
City
Driggs
State
Idaho
ZIP Code
83442
Phone
(208) 354-8181

Authorized Official

Name
JAMES C ALLEN, DDS
Title
PRESIDENT
Phone
(208) 354-8181

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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