Individual provider · Type 1 NPI
Anthony Mongillo, D.M.D, M.S.
Orthodontics and Dentofacial Orthopedics Dentistry · Idaho Falls, ID
Practice location
250 S Skyline Dr Ste 4
Idaho Falls, ID 83402-3292
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 1569 (WY) |
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | D-4708-OR (ID) |
| Dentist | 122300000X | 2014017950 (MO) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
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About NPI 1669886982
Anthony Mongillo, D.M.D, M.S.'s National Provider Identifier is 1669886982, issued on Jun 13, 2014. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Idaho Falls, ID. The record was last updated on May 9, 2024.