TWO RIVERS DENTAL; NPI #1356581326

Contact Information

TWO RIVERS DENTAL

220 S MAIN ST
CASCADE, ID 83611

Phone: 208-382-3558
Fax: 208-382-3668
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for TWO RIVERS DENTAL

NPI # 1356581326

LBN Legal business name TWO RIVERS DENTAL

Authorized official SHANE NEWTON - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/03/2009

Last updated 03/03/2009 - About 17 years ago

Identifiers

License #

D3280

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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