National Provider Identifier Database

TWO RIVERS DENTAL
Dental


Contact Information

TWO RIVERS DENTAL
220 S MAIN ST
CASCADE, ID83611
Phone: 208-382-3558
Fax: 208-382-3668
Website:
Specialty Taxonomy Code
* Dental 261QD0000X

* Indicates primary specialty

NPI Profile & details for TWO RIVERS DENTAL

NPI Number 1356581326
Legal business name
LBN
TWO RIVERS DENTAL
Authorized official SHANE NEWTON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/03/2009
Last updated 03/03/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: D3280

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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