E.t. Dental LLC

NPI #1154935039 in Kellogg, Idaho

Provider Information

NPI Number
1154935039
Entity Type
Organization
Organization Name
E.t. Dental LLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Sep 8, 2020
Last Updated
Sep 8, 2020

Practice Location

Address
418 W CAMERON AVE
State
Idaho
ZIP Code
83837-2111
Phone
(208) 682-4540

Authorized Official

Name
AARON DOLLAHITE
Title
CEO
Phone
(208) 699-0022

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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