Magic Valley Family Dental

NPI #1477723955 in Rupert, Idaho

Provider Information

NPI Number
1477723955
Entity Type
Organization
Organization Name
Magic Valley Family Dental
Primary Specialty
Dentist - General Practice
Enumeration Date
Mar 11, 2008
Last Updated
Mar 11, 2008

Practice Location

Address
115 W 100 S
City
Rupert
State
Idaho
ZIP Code
83350-9125
Phone
(208) 436-4532

Authorized Official

Name
DENISE J MALLORY
Title
OFFICE MANAGER
Phone
(208) 436-4532

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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