Kevin Mudrow DDS Pllc

NPI #1235565003 in Idaho Falls, Idaho

Provider Information

NPI Number: 1235565003
Entity Type: Organization
Organization Name: Kevin Mudrow DDS Pllc
Primary Specialty: Dentist
Enumeration Date: Sep 24, 2013
Last Updated: Sep 24, 2013

Practice Location

Address: 333 S WOODRUFF AVE
City: Idaho Falls
State: Idaho
ZIP Code: 83401-4322
Phone: (208) 524-2036

Authorized Official

Name: DR. KEVIN RICHARD MUDROW, DDS
Title: OWNER/GENERAL DENTIST
Phone: (208) 524-2036

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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