Backcountry Dental Docs, LLC

NPI #1235790510 in Kellogg, Idaho

Provider Information

NPI Number: 1235790510
Entity Type: Organization
Organization Name: Backcountry Dental Docs, LLC
Primary Specialty: Dentist
Enumeration Date: Jun 26, 2019
Last Updated: Oct 3, 2022

Practice Location

Address: 109 MCKINLEY AVE
City: Kellogg
State: Idaho
ZIP Code: 83837-2501
Phone: (208) 784-0545

Authorized Official

Name: DR. HILLARY ANNE BERRY, DMD
Title: MANAGER
Phone: (425) 409-1655

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X
Dentist	122300000X	Primary

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