Kevin Richard Mudrow, D.D.S.

NPI #1114126992 in Idaho Falls, Idaho

Provider Information

NPI Number: 1114126992
Entity Type: Individual
Name: Kevin Richard Mudrow, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Jul 12, 2007
Last Updated: Sep 11, 2013

Practice Location

Address: 333 S WOODRUFF AVE
Address 2: SUITE F
City: Idaho Falls
State: Idaho
ZIP Code: 83401-4322
Phone: (208) 524-2030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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