Organization · Type 2 NPI
Mountain River Dental
Dental Clinic/Center · Victor, ID
NPI number
1912136433
Active
Practice location
404 Lupine Drive
Victor, ID 83455-0487
Fax (208) 787-8101
Mailing address
404 Lupine Drive P.o. Box 487
Victor, ID 83455-0487
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
Other dental clinic/center providers in Victor
About NPI 1912136433
Mountain River Dental's National Provider Identifier is 1912136433, issued on Jul 6, 2009. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Victor, ID. The record was last updated on Jul 6, 2009.