West River Dental

NPI #1295478519 in Idaho Falls, Idaho

Provider Information

NPI Number: 1295478519
Entity Type: Organization
Organization Name: West River Dental
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Apr 14, 2022
Last Updated: Apr 14, 2022

Practice Location

Address: 1850 W BROADWAY ST
City: Idaho Falls
State: Idaho
ZIP Code: 83402-3044
Phone: (208) 523-3453

Authorized Official

Name: DAN R. GREENHALGH, DMD
Title: OWNER DOCTOR
Phone: (208) 523-3453

Specialties & Taxonomy Codes

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

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