NPI 1043904659
Mongillo Orthodontics, PLLC
Practice location
- Address
- 250 S Skyline Dr STE 4, Idaho Falls, ID 83402-3294
- Phone
- (208) 524-1404
Authorised official
- Name
- Anthony David Mongillo
- Title
- Sole Member/Orthodontist
- Phone
- (208) 524-1404
Registered specialties
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
Registry record
- NPI
- 1043904659
- Entity type
- Organization
- NPI issued
- 6 Jun 2023
- Record last updated
- 9 May 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.