Snake River Dental Inc.

NPI #1932360674 in Payette, Idaho

Provider Information

NPI Number: 1932360674
Entity Type: Organization
Organization Name: Snake River Dental Inc.
Primary Specialty: Dentist
Enumeration Date: Jun 24, 2008
Last Updated: Jun 24, 2008

Practice Location

Address: 925 2ND AVE N
City: Payette
State: Idaho
ZIP Code: 83661-2511
Phone: (208) 642-4782

Authorized Official

Name: JAMES H. MOORE, DDS
Title: PRESIDENT/DENTIST
Phone: (208) 642-4782

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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