Snowy River Dental Pllc | |
304 S Main St Bellevue ID 83313-6057 | |
(208) 788-2006 | |
Not Available |
Full Name | Snowy River Dental Pllc |
---|---|
Speciality | Dentist - General Practice |
Location | 304 S Main St, Bellevue, Idaho |
Authorized Official Name and Position | Danton Lafey Bradshaw (OWNER) |
Authorized Official Contact | 2086700113 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Snowy River Dental Pllc 304 S Main St Bellevue ID 83313-6057 Ph: (208) 788-2006 | Snowy River Dental Pllc 304 S Main St Bellevue ID 83313-6057 Ph: (208) 788-2006 |
NPI Number | 1346606621 |
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Provider Enumeration Date | 01/02/2016 |
Last Update Date | 01/02/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346606621 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | D4642 (Idaho) | Primary |
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