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Contact Information

TWO RIVERS DENTAL, PLLC
304 S MAIN ST
MACKAY, ID83251
 Phone: 208-588-3316
 Fax: 208-588-3166
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for TWO RIVERS DENTAL PLLC · (Female)

NPI # 1174829238
Status Active
Credentials
Entity Individual
Enumeration date 02/07/2011
Last updated 02/07/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • ID License # D4109
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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