Two Rivers Dental, Pllc

NPI #1174829238 in Mackay, Idaho

Provider Information

NPI Number: 1174829238
Entity Type: Organization
Organization Name: Two Rivers Dental, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 7, 2011
Last Updated: Feb 7, 2011

Practice Location

Address: 304 S MAIN ST
City: Mackay
State: Idaho
ZIP Code: 83251
Phone: (208) 588-3316

Authorized Official

Name: JED C SNOW, D.M.D.
Title: DENTIST
Phone: (208) 588-3316

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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