Two Rivers Dental, Pllc

NPI #1962644260 in Challis, Idaho

Provider Information

NPI Number: 1962644260
Entity Type: Organization
Organization Name: Two Rivers Dental, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 1, 2009
Last Updated: Apr 1, 2009

Practice Location

Address: 810 HWY 93 S
City: Challis
State: Idaho
ZIP Code: 83226
Phone: (208) 879-2124

Authorized Official

Name: DR. SHANE LEE NEWTON, D.M/D., P.A.
Title: OWNER
Phone: (208) 315-2842

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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