Oak Mountain Dental Pllc

NPI #1861837478 in Pocatello, Idaho

Provider Information

NPI Number: 1861837478
Entity Type: Organization
Organization Name: Oak Mountain Dental Pllc
Primary Specialty: Dentist
Enumeration Date: May 9, 2013
Last Updated: Sep 24, 2021

Practice Location

Address: 135 WARREN AVE
City: Pocatello
State: Idaho
ZIP Code: 83201-4621
Phone: (208) 237-6453

Authorized Official

Name: MR. JAKE R RICHARDS, DDS
Title: DENTIST
Phone: (208) 237-6453

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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