Potlatch Family Dental, PC

NPI #1245515832 in Potlatch, Idaho

Provider Information

NPI Number: 1245515832
Entity Type: Organization
Organization Name: Potlatch Family Dental, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 15, 2011
Last Updated: Oct 15, 2011

Practice Location

Address: 225 6TH STREET
City: Potlatch
State: Idaho
ZIP Code: 83855
Phone: (208) 875-0441

Authorized Official

Name: DR. AMMON MICHAEL PITT, D.D.S.
Title: DENTIST
Phone: (208) 875-0441

Specialties & Taxonomy Codes

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

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