Mountain River Dental

NPI #1912136433 in Victor, Idaho

Provider Information

NPI Number
1912136433
Entity Type
Organization
Organization Name
Mountain River Dental
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jul 6, 2009
Last Updated
Jul 6, 2009

Practice Location

Address
404 LUPINE DRIVE
City
Victor
State
Idaho
ZIP Code
83455-0487
Phone
(208) 787-8100

Authorized Official

Name
DR. RICHARD H GEORGE, D.M.D.
Title
OWNER
Phone
(208) 787-8100

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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