Alligator Orthodontics, LLC

NPI #1992553499 in Ammon, Idaho

Provider Information

NPI Number: 1992553499
Entity Type: Organization
Organization Name: Alligator Orthodontics, LLC
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: May 9, 2024
Last Updated: May 9, 2024

Practice Location

Address: 2805 EAGLE DR
City: Ammon
State: Idaho
ZIP Code: 83406-5769
Phone: (208) 542-1333

Authorized Official

Name: DR. ANTHONY MONGILLO, DMD
Title: MANAGER
Phone: (208) 542-1333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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Individual Providers

Provider Name	Specialty	City
DR. Charles Jared Randall, DDS	Dentist - Orthodontics and Dentofacial Orthopedics	Ammon	AI Deep Dive
John T Kalange, D.D.S., M.S.	Dentist - Orthodontics and Dentofacial Orthopedics	Boise	AI Deep Dive
DR. Rufus Van Dyke III, DDS, MCL.D	Dentist - Orthodontics and Dentofacial Orthopedics	Pocatello	AI Deep Dive

Organizations

Provider Name	Specialty	City
Randall Orthodontics, P.a.	Dentist - Orthodontics and Dentofacial Orthopedics	Ammon	AI Deep Dive
Elison Orthodontics Pllc	Dentist - Orthodontics and Dentofacial Orthopedics	Idaho Falls	AI Deep Dive

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