NPI 1356581326

Two Rivers Dental

Organisation Dental Clinic/Center Cascade, ID

Practice location

Address: 220 S Main St, Cascade, ID 83611
Phone: (208) 382-3558
Fax: (208) 382-3668
Mailing address: PO Box 498, Cascade, ID 83611-0498

Authorised official

Name: Shane L Newton
Title: Owner
Phone: (208) 634-5255

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence D3280 (ID)

Other Clinic/Center providers in Idaho →

Registry record

NPI: 1356581326
Entity type: Organization
NPI issued: 3 Mar 2009
Record last updated: 3 Mar 2009

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.