Mountain River Dental Pllc

NPI #1093147696 in Victor, Idaho

Provider Information

NPI Number: 1093147696
Entity Type: Organization
Organization Name: Mountain River Dental Pllc
Primary Specialty: Dentist
Enumeration Date: Aug 6, 2013
Last Updated: Aug 6, 2013

Practice Location

Address: 7726 LUPINE LN
City: Victor
State: Idaho
ZIP Code: 83455-5116
Phone: (208) 787-8100

Authorized Official

Name: DR. CURTIS W CARPENTER, D.D.S.
Title: PRESIDENT
Phone: (208) 201-8649

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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