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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

NPI Number 1174829238
LBN Legal business name TWO RIVERS DENTAL, PLLC
Authorized official JED SNOW - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 02/07/2011
Last updated 02/07/2011 - About 15 years ago
Identifiers
ID License # D4109
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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